Scaffold for Tissue Growth and Repair

ABSTRACT

Provided is an electroactive structure and method for growing isolated differentiable cells comprising a three dimensional matrix of fibers formed of a biocompatible synthetic piezoelectric polymeric material, wherein the matrix of fibers is seeded with the isolated differentiable cells and forms a supporting scaffold for growing the isolated differentiable cells, and wherein the matrix of fibers stimulates differentiation of the isolated differentiable cells into a mature cell phenotype on the structure.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit under 35 U.S.C. §119(e) of U.S.Provisional Patent Application Ser. No. 61/546,257; filed: Oct. 12,2011, which is hereby incorporated by reference its entirety. Inaddition, this application is a divisional patent application claimingpriority benefit to U.S. application Ser. No. 13/651,296, filed Oct. 12,2012, which was a continuation-in-part application claiming prioritybenefit to U.S. application Ser. No. 12/661,264, filed Mar. 12, 2010,which was a continuation-in-part application claiming priority benefitto U.S. application Ser. No. 12/411,320, filed Mar. 25, 2009, whichclaimed the benefit of U.S. Provisional Application Ser. No. 61/159,751,filed Mar. 12, 2009.

FIELD OF THE INVENTION

This invention relates to the fields of biotechnology, neuroscience, andregenerative medicine, such as, for example, cell growth/differentiationand/or tissue repair.

BACKGROUND

It has long been a goal of orthopeadics to identify rapid and effectivemeans and materials for repairing complex tissues, including connectivetissues, such as bone and cartilage, due to defects caused by, forexample, injury, disease, wounds, or surgery. Tissue engineeringprinciples have been utilized in recent years as an approach for suchtissue repair and may be a suitable approach even for more complextissue types.

The general approach to the use of tissue engineering in the repairand/or regeneration of tissue is to combine cells and/or biologicalfactors with a biomaterial that acts as a scaffold for tissuedevelopment. The cells should be capable of propagating on the scaffoldand acquiring the requisite organization and function in order toproduce a properly functioning tissue. Such cells might includemesenchymal stem cells (MSCs) which are adult stem cells that arethought, due to their proliferative capacity and ability, todifferentiate based on environmental cues into various connective tissuelineages, including bone and cartilage, and could be used in combinationwith engineered biomaterials for more complex tissue reconstructions,such as connective tissues like bone and/or cartilage. In addition, thebiomaterials for use in such tissue engineering approaches might includecertain “smart” biomaterials which may optimally imitate the naturalorganization and/or properties of a complex tissue sought to be repairedor regenerated.

Innovative technologies are needed for tissue engineering of inherentlycomplex tissues, and in particular, musculoskeletal connective tissuesuch as articular cartilage and the underlying bone tissue. Accordingly,compositions and methods that are capable of inducing bone and/orcartilage growth and repair are provided herein.

SUMMARY

Described herein are compositions and methods useful for promoting thegrowth and/or differentiation and/or repair of a cell and/or tissue, forexample, a differentiable cell such as an isolated stem cell orprogenitor cell. In one aspect that isolated stem cell or progenitorcell is a bone or cartilage stem or progenitor cell.

In certain aspects, the present invention provides an electroactive, orpiezoelectric, biomaterial as an electroactive scaffold for facilitatinggrowth, differentiation, and/or repair of a cell and/or a tissue. Thepiezoelectric material acts as a highly sensitive mechanoelectricaltransducer that will generate charges in response to minute vibrationalforces. Further provided are piezoelectric compositions comprising athree-dimensional matrix of micro and/or nanofibers of piezoelectricsynthetic or biological polymers used as an implantable scaffolding fordelivery of differentiable stem/progenitor cells, e.g., humanmesenchymal cells, bone or cartilage stem/progenitor cells or the like,in tissue engineering applications and methods of preparing them. Thepiezoelectric scaffolds, which demonstrate electrical activity inresponse to minute mechanical deformation, allow the achievement oflocal electric fields characteristic of the natural extracellular matrixobserved during development and regeneration or repair.

In one aspect, the present invention provides an electroactive structurefor growing isolated differentiable cells that comprises a threedimensional matrix of micro- and/or nanosized fibers formed of abiocompatible synthetic piezoelectric polymeric material wherein thematrix of fibers is seeded with the isolated differentiable cells andforms a supporting scaffold for growing the isolated differentiablecells, and wherein the matrix of fibers alone or in combination withother factors stimulates differentiation of the isolated differentiablecells into a mature cell phenotype on the structure. In any of theembodiments described herein, the micro- or nanofibrous matrix of theelectroactive structure or scaffold includes a random, and/or aligned,and/or patterned fibrous mesh of fibers.

In other aspects, presently described are polymer scaffolds forpromoting tissue growth, differentiation, and/or repair. In an exemplaryembodiment of this aspect, the scaffold matrix is comprised of a polymerthat demonstrate piezoelectric properties. In certain embodiments, thepiezoelectric polymer is a polyvinyl polymer or co-polymer, for example,a polyvinylidine fluoride (PVDF), trifluoroethylene (TrFE), orpermanently piezoelectric poly (vinylidene fluoride trifluoroethylene)(PVDF-TrFE) copolymer. In another aspect, the piezoelectric polymer isannealed (e.g., annealed PVDF-TrFE).

In another aspect, presently described are polymer scaffolds formed byelectro spinning. In an exemplary embodiment of this aspect, thescaffold is comprised of a matrix of micro and/or nanosized fibersformed by electrospining a piezoelectric polymer (i.e., a polymer thatexhibits piezoelectric properties). In certain embodiments, thepiezoelectric polymer to be electrospun into fibers comprises apolyvinyl polymer or co-polymer, for example, a polyvinylidine fluoride(PVDF), trifluoroethylene (TrFE), or permanently piezoelectric poly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE) copolymer. Inanother embodiment, the matrix fibers are a non-woven mesh of micro-and/or nanosized fibers. In another embodiment, the three dimensionalmatrix of fibers formed of a biocompatible synthetic piezoelectricpolymeric material is formed by electrospinning. In any of theembodiments described herein, the polymer tissue scaffold can be formedby electrospinning at a low voltage, e.g., 12 kV. In other embodiments,the polymer tissue scaffold can be formed by electrospinning at a highvoltage, e.g., 25 kV. In another aspect, the piezoelectric polymer isannealed, for example, by heating or by chemical means. In certainembodiments, the polymer tissue scaffold is formed from electrospun,annealed PVDF-TrFE.

In some embodiments, the low voltage used during electrospinning can beabout 11 kV or less, or about 12 kV, or about 13 kV. In otherembodiments, the low voltage can be between about 5-8 kV, or between8-11 kV, or between about 10-13 kV.

In other embodiments, the high voltage used during electrospinning canbe about 15 to about 30 kV. In other embodiments, the high voltage canbe between about 15-20 kV, or between about 18-23 kV, or between about21-27 kV, or between about 24-30 kV, or between about 27-33 kV, orbetween about 30-40 kV.

In still other embodiments, the voltage applied during theelectrospinning process can be varied between two or more voltages. Incertain embodiments, the voltage during electrospinning can be variedbetween a low voltage, e.g., 10-13 kV, and a high voltage, e.g., 15-30kV. The number and timing of the oscillations between two or morevoltages are unrestricted. For example, during elecrospinning, thevoltage can be varied between 11 kV and 30 kV, or between 11 kV and 25kV, or between 11 kV and 15 kV, every nanosecond, microsecond,millisecond, second, or every multiple seconds, or even minutes.

In still other embodiments, the temperature(s) of any of the materialsinvolved in the electrospinning process (e.g., the electrospinningapparatus, the material being electrospun, or the target substrate, suchas an aluminum plate) may be any suitable temperature(s) and suchtemperatures may be the same or difference, and further, suchtemperatures may vary during the process. Suitable temperatures incertain embodiments can include, for example, about 25 degrees Celsius,or about 25-30 degrees Celsius, or between about 25-50 degrees Celsius,or any temperature below about 75 degrees Celsius.

In certain aspects of the invention, the differentiable cell matures ordifferentiates within and/or on the scaffold. The differentiation statusof a cell can be determined by assessing suitable phenotypic markers,e.g., cell surface proteins, and/or gene expression profiles, which arespecific for a differentiated cell. In certain aspects, the mature cellphenotype comprises a bone or cartilage cell phenotype. Therefore, incertain embodiments, the isolated differentiable cells are multipotenthuman mesenchymal cells or bone or cartilage (e.g., osteocyte orchondrocyte) stem/progenitor cells. In certain aspects, the cells aregrown on a polymer tissue scaffold as described herein, wherein thescaffold is comprised within a compression bioreactor.

In another aspect, the present invention provides a composition for usein tissue engineering that comprises (a) isolated differentiable cells,and (b) a supporting electroactive scaffold for growing the isolateddifferentiable cells, the supporting scaffold comprising a threedimensional matrix of fibers formed of a biocompatible syntheticpiezoelectric polymeric material, wherein the matrix of fibers is seededwith the isolated differentiable cells and forms a supporting scaffoldfor growing the isolated differentiable cells, and wherein the matrix offibers stimulates differentiation of the isolated differentiable cellsinto a mature cell phenotype on the structure. In one embodiment, thebiocompatible synthetic piezoelectric polymeric material ispoly(vinylidene fluoride trifluoroethylene) copolymer. In anotherembodiment, the three dimensional matrix of fibers is a non-woven meshof nanofibers. In still another embodiment, the three dimensional matrixof fibers formed of a biocompatible synthetic piezoelectric polymericmaterial is formed by electrospinning. In certain embodiments, theisolated differentiable cells are multipotent human mesenchymal cells,or neuronal stem/progenitor cells. In another embodiment, the maturecell phenotype comprises a neuronal cell phenotype. In anotherembodiment, step (a) further comprises the step of obtaining thedifferentiable human mesenchymal cells from bone marrow or other tissue,e.g., brain or spine.

In an additional aspect, presently described are polymeric scaffolds formodulating or promoting the growth, differentiation, and/or repair of acell or tissue, for example, a mesenchymal stem cell, neuronalstem/progenitor cell, neuron, or the like. In certain embodiments, thepolymeric scaffolds may include a matrix producing or supporting cell,e.g., a fibroblast. In further aspects, the polymeric scaffolds providedby the invention can be used alone or in combination with a cell topromote repair of damaged tissue, e.g., nerve tissue, in a subject. Incertain embodiments, the cell or cells seeded in or on the scaffoldcomprises a mesnechymal stem cell. In additional embodiments, thepolymeric scaffolds are seeded with a matrix producing or supportingcell.

In an additional aspect, the polymeric scaffolds provided by theinvention are generated or fabricated in order to more closely mimic thestructure of the natural extracellular matrix. In an exemplaryembodiment of this aspect, the scaffold is comprised of an electrospunpolymer that demonstrates piezoelectric properties. In certainembodiments, the electrospun piezoelectric polymer is a polyvinylpolymer or co-polymer, for example, a permanently piezoelectric poly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE) copolymer. Incertain embodiments, the PVDF-TrFE is fabricated into a fibrous scaffoldand the fibers are random, aligned or a combination of both. In certainembodiments the scaffold matrix, and/or fibers additionally comprise anexogenous protein or compound to promote cell growth, differentiation,and/or repair, including for example, growth factors, chemokines,polysaccharides, glycans, or the like.

In another aspect, described herein are methods for promoting and/orenhancing the growth, differentiation, and/or repair of a cell or of atissue, e.g., a bone or cartilage tissue, comprising seeding a cell on ascaffold comprised of an electrospun polymer that demonstratespiezoelectric properties, wherein the scaffold promotes the growth,differentiation, and/or repair of a cell or tissue within or outside ofthe scaffold matrix. In certain embodiments, the electrospunpiezoelectric polymer is a polyvinyl polymer or co-polymer, for example,a permanently piezoelectric poly (vinylidene fluoride trifluoroethylene)(PVDF-TrFE) copolymer. In certain embodiments, the cell is a mesenchymalstem cell or other progenitor cell, e.g., a chrondrocyte progenitorcell, chondroblast progenitor cell, osteoblast progenitor cell, anosteocyte progenitor cell, or an osteoclast progenitor cell, or acombination thereof. In additional embodiments, the cell is seededtogether with a matrix producing, and/or supporting cell or progenitorthereof.

In a particular embodiment, the present invention provides anelectroactive structure for growing and differentiating a differentiablecell comprising a three dimensional matrix of electrospun biocompatiblesynthetic piezoelectric polymer fibers formed by electrospinning thepolymer at a high electric potential, wherein the fiber matrix forms ascaffold for supporting cell growth and differentiation; and wherein thescaffold conditions are sufficient to induce differentiation of amesenchymal stem cell into either an osteogenic or chondrogenicphenotype.

In certain embodiments, the biocompatible synthetic piezoelectricpolymer is a homopolymer, a copolymer or combination thereof.homopolymer is a polyvinylidene fluoride (PVDF), or a ifluoroethylenepolymer.

In other embodiments, the copolymer is a poly(vinylidene fluoridetrifluoroethylene) (PVDF-TrFE) copolymer.

In yet other embodiments, the biocompatible synthetic piezoelectrichomopolymer fibers are annealed.

In still other embodiments, the biocompatible synthetic piezoelectriccopolymer fibers are annealed.

In still other embodiments, the fibers further comprise a growth factorcapable of further promoting the differentiation of the mesenchymal stemcell into a osteogenic or chondrogenic phenotype. Such growth factor canbe associated with the matrix of fibers through at least one of acovalent interaction, a non-covalent interaction or a combination ofboth.

In other embodiments, the matrix fibers can be a non-woven mesh ofnanofibers, microfibers or a combination of both. The matrix fibers canalso be arranged in the matrix randomly, substantially aligned or acombination of both.\

In still other embodiments, the fibers are thermally or chemicallyannealed, and wherein after annealing the fibers demonstrate enhancedpiezoelectric characteristics, crystal organization or a combination ofboth.

In yet other embodiments, the fibers are thermally or chemicallyannealed, and wherein after annealing the fibers demonstrate enhancedpiezoelectric characteristics, crystal organization or a combination ofboth.

In still other embodiments, the osteogenic or chondrogenic phenotype isdemonstrated by at least one of increased collagen expression, growth ora combination thereof.

In other embodiments, the high electric potential is a voltage of atleast between 15 to 30 kV.

In one embodiment, the high electric potential is 25 kV.

In still a further embodiment, the invention provides an implantableelectroactive scaffold produced according to the steps comprising: (a)electropsinning a biocompatible synthetic piezoelectric polymericmaterial at at least 25 kV to form a three-dimensional matrix ofpiezoelectric fibers, wherein the fibers have an average fiber diameterof from about 500 nm to about 5 μm; (b) annealing the electrospunpiezoelectric polymeric fibers; and (c) seeding the annealedthree-dimensional matrix of piezoelectric fibers with a mesenchymal stemcell under conditions sufficient to induce differentiation of amesenchymal stem cell into either an osteogenic or chondrogenicphenotype.

In other embodiments, the biocompatible synthetic piezoelectricpolymeric material is at least one of a homopolymer, a copolymer or acombination of both.

In still the embodiments, the homopolymer is a polyvinylidene fluoride(PVDF), or a trifluoroethylene polymer or a copolymer such as apoly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE) copolymer.

In other embodiments, the method of making the material can comprise thestep of shaping the scaffold using a presses or mold.

In still another embodiment, the invention provides a method forrepairing bone or cartilage tissue in a subject comprising the steps:(a) isolating at least one differentiable bone or cartilage progenitorcell from a donor subject; (b) preparing the electroactive scaffold ofthe invention; (c) seeding the cell scaffold with the isolated bone orcartilage progenitor cell; (d) growing the bone or cartilage progenitorcell on the cell scaffold ex vivo or in vitro; and (e) implanting thescaffold comprising the bone or cartilage progenitor cell at the site ofinjury, wherein the bone or cartilage progenitor cell differentiatesinto a mature bone or cartilage cell phenotype on the scaffold.

The preceding general areas of utility are given by way of example onlyand are not intended to be limiting on the scope of the presentdisclosure and appended claims. Additional objects and advantages of thepresent invention will be appreciated by one of ordinary skill in theart in light of the instant claims, description, and examples. Forexample, the various aspects and embodiments of the invention may beutilized in numerous combinations, all of which are expresslycontemplated by the present description. These additional objects andadvantages are expressly included within the scope of the presentinvention.

BRIEF DESCRIPTION OF THE DRAWINGS

The patent or application file contains at least one drawing executed incolor. Copies of this patent or patent application publication withcolor drawing(s) will be provided by the Office upon request and paymentof the necessary fee.

The accompanying drawings, which are incorporated into and form a partof the specification, illustrate several embodiments of the presentinvention and, together with the description, serve to explain theprinciples of the invention. The drawings are only for the purpose ofillustrating an embodiment of the invention and are not to be construedas limiting the invention.

FIG. 1 depicts SEM images (magnification of 3500) of aligned (left) andrandom (right) electrospun PVDF-TrFE scaffolds;

FIG. 2 depicts DSC (heat flow) and TSDC (current) results forunprocessed powder (a) and electrospun PVDF-TrFE (b). Electric responseof PVDF-TrFE scaffold (c) when initializing deformation and (d) 25 msduration while deforming;

FIG. 3 shows confocal images of PC-12 cells cultured on (a) PVDF-TrFEmeshes in induction media; (b) in standard growth media; and (c) PC-12cells on PLLA meshes in induction media (60× objective D); and metabolicactivity of PC-12 cells at 10 days in culture *P<0.05 for PVDF-TrFEversus collagen;

FIG. 4 shows chondroadherin and focal adhesion kinase (FAK) geneexpression in human mesenchymal stem cells (hMSCs) cultured for 28 dayson PLLA and PVDF-TrFE scaffolds. Cell pellet cultures serve as controls;

FIG. 5 shows glycosaminoglycan production (sGAG) for human mesenchymalstem cells cultured in chondrogenic induction media on PLLA andPVDF-TrFE meshes at 28 days. Pellet cultures served as a positivecontrol. *p<0.05;

FIG. 6 shows (a) viability and growth of human skin fibroblasts onelectrospun PVDF-TrFE fiber scaffold compared to tissue culturepolystyrene (TCPS); (b) SEM image of electrospun PVDF-TrFE fibers;

FIG. 7 shows confocal scanning laser microscopy images of human skinfibroblasts attached to PVDF-TrFE fibers after 1 day and after 7 days ofcell culture;

FIG. 8 depicts PC12 cells stained with Phalloidin on random (a) oraligned (b) PVDF-TrFE and collagen (c) in induction media (20×). (d) MTTviability assay for PC12 cells on random PVDF-TrFE and collagen ininduction media. Cell proliferation on collagen was higher thanPVDF-TrFE (p>0.05);

FIG. 9 depicts DRGs stained with Vybrant® CFDA SE cell tracker at day 3on random (left) and aligned (right) PVDF-TrFE scaffolds (4×);

FIG. 10 depicts an image of contused spinal cord in the rat a) aftercontusion and b) after the insertion of the PVDF-TrFE scaffold;

FIG. 11 provides confocal microscopy images of hNPCs on PVDF-TrFE-L a)random, b) random-annealed, c) aligned, d) aligned-annealed (all at 40×obj), and e) laminin (20× obj.); and

FIG. 12 Fraction of positive nestin, tubulin, and GFAP on variousscaffolds. *Nestin positive cells were the highest on laminin. **Tubulinpositive cells were the lowest on laminin in comparison to annealed,random and aligned PVDF-TrFE(L) and annealed random PVDF-TrFE(S).***Tublin positive cells on annealed, aligned PVDF-TrFE(L) wassignificantly greater than as-spun aligned PVDF-TrFE(L). Very littleGFAP positive cells could be detected in all of the samples.

FIG. 13 shows SEM images of electro spun PVDF scaffolds (scale bar: 10μm).

FIG. 14 shows XRD patterns of: (a) raw PVDF pellets, (b) PVDF film, (c)Melt-spun fiber at 240° C., (d) PVDF—30 kV, (e) PVDF—25 kV, (f) PVDF—20kV, (g) PVDF—15 kV and (h) PVDF—12 kV.

FIG. 15 shows FTIR spectra of: (a) PVDF—30 kV, (b) PVDF—25 kV, (c)PVDF—20 kV, (d) PVDF—15 kV and (e) PVDF—12 kV (f) Melt-spun fiber at240° C., (g) PVDF film and (h) raw PVDF pellets.

FIG. 16 shows confocal images of human MSCs on PVDF electrospun mats atday 7 and 14. Green is F-actin, and blue is nucleus, 20× objective,scale bar 100 μm.

FIG. 17 depicts cell proliferation on PVDF electrospun mats versuscontrol material. *p<0.05 significantly different between control andother groups at days 7, 10 and 14.

FIG. 18 Alkaline phosphatase activity normalized to cell number atdifferent time points. *p<0.05 between control and other groups at day7, **p<0.05 between all groups at day 10, and ***p<0.05 between PVDF-25kV and control at day 21.

FIG. 19 Mineralization normalized to cell number at different timepoints. *p<0.05 at day 10 between PVDF-25 kV and other groups, **p<0.05between control and other groups at day 21.

FIG. 20 shows cell number for human mesenchymal stem cells on annealedand unannealed PVDF-TrFE scaffolds in a compression bioreactor (CartigenCompression Bioreactor, TISSUE GROWTH TECHNOLOGIES, Minnesota, US). Theresults show a statistically higher number of cells on annealedPVDF-TrFE (display greater piezoelectric activity) at day 12. (*p<0.05).

FIG. 21 shows: (A) SEM micrograph of PVDF-TrFE thick scaffolds for invivo use and (B) confocal image of cross-section of MSCs loaded ontoscaffolds. Cells are stained with DiI, a cytoplasm stain—cells appearlarge and rounded in morphology (40× objective).

FIG. 22 shows: (A) Setup to test inverse piezoelectric effect, top isPVDF-TrFE and bottom is polyester. (B) Movement of fiber after applyingAC voltage (Bar=deflection distance).

FIG. 23 shows: High resolution AFM image of piezoelectric PVDF-TrFEfiber. Nanoscale roughness was apparent.

FIG. 24 shows: (A) AFM image of piezoelectric PVDF-TrFE demonstratingnanoscale roughness. (B) PFM image and corresponding PFM voltages (V)for the same area.

FIG. 25 shows: Confocal microscopy images of Human MSCs seeded onPVDF-TrFE meshes and cultured in (A) growth media, (B) chondrogenicinduction media for 14 days in culture. FITC-phalloidin (green) foractin and DAPI (blue stain) for nucleus. 20× objective

FIG. 26 shows: Glycosaminoglycan production (sGAG) for human MSCscultured in condrogenic induction media on PLLA and PVDF-TrFE meshes at28 days. Pellet cultures serve as positive control. *p<0.05

FIG. 27 shows: Gene expression of human MSCs cultured for 28 days onPLLA and PVDF-TrFE scaffolds. Cell pellet cultures served as positivecontrol. (CCM−=condrogenic culture media without TGF-β3;CCM+=chondrogenic culture media with TGF-β3; MSCGM=standard growthmedia). (A) Chondroadherin, (B) FAK, (C) Sox9, and (D) Collagen Type II.

FIG. 28 shows: Gene expression of human MSCs cultured for 14 and 28 daysannealed piezoelectric and unannealed PVDF-TrFE scaffolds. All cultureswere in CCM+=chondrogenic culture media with TGF-β3, unless otherwisenoted. (A) collagen type II, (B) aggrecan, (C) chondroadherin (D) Sox9and (E) Sox2 (standard growth media). *p<0.05.

FIG. 29 demonstrates use of PVDF-TrFE scaffold for in vivo repair ofosteochondral defect. Images (A)-(D) are histological images ofosteochondral defects, cross-section, containing PVDF-TrFE at 12 weekspost-implantation (n=3). (A) shows an upper portion of an osteochondraldefect at 20× objective, stained with H&E (hematoxylin and eosinhistological stain). (B) shows the entire defect at 4× objective,stained with toluidine blue, stains for proteoglycans in purple (arrowis a processing artifact). (C) shows lower left interface, at 20×objective, stained with H&E. (D) lower right interface, at 20×objective, stained with H&E. Whitish grey areas are the scaffold. Outersurface of the defect is continuous with the native cartilage. Thedefect is filled with cartilage and the arrows in (C) and (D) show bloodvessels and bone tissue from the subchondral area. Cartilage and bonetissue integrated and was in direct opposition with the fibers.

DETAILED DESCRIPTION

The following is a detailed description of the invention provided to aidthose skilled in the art in practicing the present invention. Those ofordinary skill in the art may make modifications and variations in theembodiments described herein without departing from the spirit or scopeof the present invention. Unless otherwise defined, all technical andscientific terms used herein have the same meaning as commonlyunderstood by one of ordinary skill in the art to which this inventionbelongs. The terminology used in the description of the invention hereinis for describing particular embodiments only and is not intended to belimiting of the invention. All publications, patent applications,patents, figures and other references mentioned herein are expresslyincorporated by reference in their entirety.

Described herein are compositions and methods useful for promoting thegrowth, differentiation, and/or repair of a cell and/or tissue, e.g., astem or progenitor cell. In particular, the present invention is basedupon the surprising and unexpected discovery that cell and/or tissuegrowth, differentiation, and/or repair is/are enhanced when grown on athree-dimensional electroactive structure or scaffold comprisingmicrosized or nanosized fibers, or both, of a piezoelectric polymermaterial. Unless otherwise indicated, the term “polymer” refers toeither or both of a homopolymer and heteropolymer (i.e., co-polymer).The compositions and methods provided by the invention are useful as aresearch tool, a surgical implantation device, a cell or tissue culturedevice or a combination thereof for in vitro, in vivo, and/or ex vivoculture of a cell and/or tissue, e.g., a stem or progenitor cell, orother cell or tissue for the generation of tissue for repair of damagedtissue, for allographic or xenographic transplantation or anycombination thereof.

The following patents and published patent applications are relevant tothe subject matter of the present invention: U.S. Pat. Nos. 6,689,166and 6,790,528; and U.S. Published Pat. App. Nos. 2004-0018226;2006-0204539; 2009-0325296; 2009-0028921; and 2006-0128012, thedisclosures of which are all incorporated herein by reference in theirentirety for all purposes.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which this invention belongs.

As used herein, the term “stem cell” refers to undifferentiated cellshaving high proliferative potential with the ability to self-renew thatcan migrate to areas of injury and can generate daughter cells that canundergo terminal differentiation into more than one distinct cellphenotype. These cells have the ability to differentiate into variouscells types and thus promote the regeneration or repair of a diseased ordamaged tissue of interest.

The term “progenitor cell” as used herein refers to an immature cellisolated from a tissue, including, e.g., bone marrow, brain, spinalcord, heart, adipose, connective, epithelium, endothelium, or the like,that can be isolated by growing suspensions of the cells in culturedishes with added growth factors. Progenitor cells are referred to ascolony-forming units (CFU) or colony-forming cells (CFC). The specificlineage of a progenitor cell is indicated by a suffix, such as, but notlimited to, CFU-F (fibroblastic).

As used herein, the term “polymer” refers to a macromolecule formed bythe chemical union of five or more identical combining units calledmonomers. In most cases, the number of monomer is quite large and oftenis not precisely known. In synthetic polymers, this number may becontrolled to a predetermined extent. Combinations two, three, or fourmonomers are called, respectively, dimers, trimers, and tetramers, andare known collectively as oligomers. Polymers may be inorganic (e.g.,siloxane, sulfur chains, black phosphorus, boron-nitrogen, silicones) ororganic (meaning containing carbon). Organic polymers may be natural[e.g., polysaccharides, such as starch, cellulose, pectin, seaweed gums,vegetable gums; polypeptides, such as casein, albumin, globulin,keratin, insulin, DNA; and hydrocarbons], synthetic [such asthermoplastics (unvulcanized elastomers, nylon, polyvinyl chloride, poly(vinylidene fluoride trifluoroethylene) linear polyethylene,polystyrene, polypropylene, polyurethane, acrylate resins);thermosetting (e.g., vulcanized elastomers, crosslinked polyethylene,phenolics, alkyds, polyesters), and semisynthetic (e.g., cellulosics,such as rayon, methylcellulose, cellulose acetate; and modifiedstarches)]. The term “homopolymer” refers to a natural or syntheticpolymer derived from a single monomer. The term “heteropolymer” refersto a natural or synthetic polymer derived from more than one monomersubunit (i.e., co-polymer). Unless otherwise indicated, the term“polymer” is used generally to refer to both homopolymers andheteropolymers (i.e., co-polymer) as described herein.

The term “cellular differentiation” as used herein refers to the processby which cells acquire a cell type.

The term “ΔHf” refers to Heat of Fusion.

The term “nanoscale fiber” generally refers to fibers whose diameterranges from about 1 to about 1000 nanometers.

The term “piezoelectric material” as used herein refers to any materialthat exhibits piezoelectric properties or effects. The terms“piezoelectric properties” or “piezoelectric effects” are usedinterchangeably to refer to the property exhibited by piezoelectricmaterials of becoming electrically polarized when mechanically strainedand of becoming mechanically strained when an electric field is applied.

The present invention described hereinabove has both human andveterinary utility. The term “subject” as used herein therefore includesanimals, e.g., those of mammalian origin, including humans.

The term “Tm” refers to melting point.

The term “growth factor” refers generally to bioactive cell signalingmolecules, including cytokines and chemokines, which are known to elicitphysiological effects through their interaction with cell surfacereceptors (typically receptor tyrosine kinases, Ser/Thr kinases,immunoglobulins or GPCRs) on a cell. The phyiological effects of growthfactor binding to its receptor include, for example, changes in geneexpression, and/or cell proliferation, differentiation, activation,quiescence, or apoptosis. In certain cases, growth factors arepleiotropic, i.e., they may induce different physiological effectsdepending on the concentration, cell type, and/or cell status. In any ofthe embodiments provided herein, the fiber, matrix, and/or scaffold mayadditionally include one or more growth factors to enhance, e.g., cellor tissue growth, differentiation, and/or repair.

Where a range of values is provided, it is understood that eachintervening value, to the tenth of the unit of the lower limit unlessthe context clearly dictates otherwise, between the upper and lowerlimit of that range and any other stated or intervening value in thatstated range is encompassed within the invention. The upper and lowerlimits of these smaller ranges which may independently be included inthe smaller ranges is also encompassed within the invention, subject toany specifically excluded limit in the stated range. Where the statedrange includes one or both of the limits, ranges excluding either bothof those included limits are also included in the invention.

Although any methods and materials similar or equivalent to thosedescribed herein can also be used in the practice or testing of thepresent invention, the preferred methods and materials are nowdescribed. All publications mentioned herein are incorporated herein byreference to disclose and described the methods and/or materials inconnection with which the publications are cited.

It must be noted that as used herein and in the appended claims, thesingular forms “a”, “and”, and “the” include plural references unlessthe context clearly dictates otherwise. All technical and scientificterms used herein have the same meaning.

In certain aspects, the present invention provides an electroactive, orpiezoelectric, biomaterial as an electroactive scaffold for enhancing orfacilitating growth, differentiation, and/or repair of a cell and/or atissue. The piezoelectric material acts as a highly sensitivemechanoelectrical transducer that will generate charges in response tominute vibrational forces. In certain embodiments, the inventionprovides piezoelectric compositions comprising a three-dimensionalmatrix of micro- and/or nanofibers of piezoelectric synthetic orbiological polymers used as an implantable scaffolding for the growthand/or delivery of differentiable cells, for example, mesenchymal stemcells, progenitor cells, including neuronal stem/progenitor cells or anyother cell for tissue engineering applications and methods of preparingthem. The piezoelectric scaffolds, which demonstrate electrical activityin response to minute mechanical deformation, allow the achievement oflocal electric fields characteristic of the natural extracellular matrixobserved during development and regeneration or repair. Thedifferentiable cells can be isolated according to well known methods andmay be isolated from any suitable subject, for example, a mammal,including a human.

Random, aligned, and patterned nano-fibrous mesh and three-dimensionalstructures can be fabricated by altering collection methods as describedherein. The topographic features of nano-aligned-fibrous scaffoldscreate contact guidance. For example, in the case of a isolateddifferentiable neuronal stem or progenitor cell, the aligned fibrousscaffold fabricated in accordance with the present description canfurther facilitate axonal extension. Experimental results havedemonstrated for certain exemplary embodiments, enhanced neuronaldifferentiation and neurite extension on PVDF-TrFe meshes. Also, cellson aligned nanofiber scaffolds extend neurites unidirectionally,parallel with the aligned fibers.

Specialized protein receptors that have the capability of selectivelybinding or adhering to other signaling molecules coat the surface ofevery cell in the body. Cells use these receptors and the molecules thatbind to them as a way of communicating with other cells and to carry outtheir proper functions in the body. Each cell type has a certaincombination of receptors, or markers, on their surface that makes themdistinguishable from other kinds of cells. In certain embodiments,comprising a neuronal stem/progenitor cell, piezoelectric polymers caninduce transient change of surface charge without requiring additionalenergy sources or electrodes and have been shown to yield a higher levelof neuronal differentiation and neurite outgrowth of mouse neuroblastomacells.

Therefore, in one aspect the present invention provides a novelelectroactive structure or scaffold to be used to promote growth,differentiation, and/or repair of a differentiable stem/progenitor cell,e.g., a mesenchymal cell or neuronal stem/progenitor cell. As describedherein, in an exemplary embodiment, the piezoelectric property of thefiber matrix promotes neurite extension by neuronal stem/progenitorcells incorporated into the piezoelectric scaffold. The piezoelectricscaffold in an aligned nanofibrous format provides the appropriatephysical cues to promote axonal regeneration.(8-10) By combining thescaffold with neuronal stem/progenitor cells, the cells may provide thetherapeutic benefit of neuroprotection(11) and/or functionally integrateinto the spared spinal cord circuitry (e.g. forming new oligodendrocytesand/or neurons)(12;13) to improve therapeutic outcomes.

Thus, in an exemplary embodiment, the invention provides anelectroactive structure for growing an isolated differentiablestem/progenitor cell comprising a three dimensional matrix of fiberscomprising a biocompatible synthetic piezoelectric polymeric material,wherein the matrix of fibers is seeded with at least one isolateddifferentiable stem/progenitor cell and forms a supporting scaffold forgrowing the isolated differentiable stem/progenitor cell. In certainembodiments, the isolated differentiable cell is a differentiableneuronal stem/progenitor cell or other cell or progenitor cell capableof being differentiated into a nerve cell. In another embodiment, thematrix of piezoelectric fibers stimulates growth, differentiation,and/or repair of the isolated differentiable neuronal progenitor cellinto a mature neuronal cell phenotype on the structure, for example, aperipheral nerve, brain or spinal cord neuron. In this context, it is tobe understood that the word “on” is used in broad sense and refers to,and includes, by way of example, cells growing partially or completely“on,” “in,” “within,” and/or “through” the structure.

After spinal cord injury (SCI) unidirectional aligned structure of theaxons is disrupted [1] and restoring the original structure is necessaryfor functional recovery. A tissue-engineered bridging device asdescribed herein is a promising method to guide axonal outgrowth forrepair of SCI. However, the cell favors the implantation site more [1],thus appropriate topographic cues within the bridging device may becrucial in successfully guiding axons to extend out of the bridge and toenhance host-implant interaction. As discussed above, local electricfields have been measured during neural development or after nerveinjury in various vertebrate systems [2]. Electric fields generated viaelectrodes have been shown to influence growth and orientation ofneurons in vitro [3]. It was surprisingly and unexpectedly discoveredthat piezoelectric polymers can induce transient change of surfacecharge without requiring additional energy sources or electrodes andhave been shown to yield a higher level of cell growth, differentiation,and repair as exemplified by the observed neuronal differentiation andneurite outgrowth of mouse neuroblastoma cells [4].

In any of the embodiments described herein, the biocompatible syntheticpiezoelectric polymer may be comprised of any suitable polymericmaterial that demonstrates piezoelectric properties. In certainembodiments, the electrospun piezoelectric polymer is a polyvinylpolymer or co-polymer, for example, a permanently piezoelectric poly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE) copolymer. Thesteric hindrance of the TrFe polymer in PVDF-TrFE forces the copolymerinto an all-trans configuration and is considered piezoelectric [5].

In certain embodiments, the piezoelectric polymeric scaffold asdescribed herein is formed by electrospinning. Electrospinning is usedto synthesize polymeric tissue engineering scaffolds by applying a highvoltage to an ejectable polymer solution. The basic principle behindthis process is that an electric voltage sufficient enough to overcomethe surface tension of a polymeric solution causes the polymer dropletsto elongate so that the polymer is splayed randomly as very fine fibers,which when collected on a grounded metal plate, form a non-woven mat ormesh. Traditionally, electrospinning has yielded non-woven (i.e., mesh)mats (also called matrices and scaffolds) of nanometer sized fiberdiameters and nanometer sized pore diameters. However, in order forcells to infiltrate into a scaffold and proliferate, micron sized fiberdiameters and micron sized pore diameters are optimal. Since thediameter of a cell is approximately 10 μm to 20 μm, pore sizes at thecellular level or above are needed to allow for cell infiltration. In anexemplary embodiment, the matrix fibers comprise a non-woven mesh ofrandom and/or aligned nanofibers or microfibers or a combinationthereof.

In certain embodiments, the electrospun fibers have an average fiberdiameter of from about 100 nm to about 100 microns. In an additionalembodiment, the electrospun fibers have an average fiber diameter offrom about 600 nm to about 5 microns. In a preferred embodiment, theelectrospun fibers are PVDF-TrFE fibers and have an average fiberdiameter of from about 750 microns to about 5 microns.

In certain embodiments, the polymer, e.g., PVDF-TrFE, is fabricated intoa fibrous matrix scaffold and the fibers are arranged randomly,substantially or approximately aligned or a combination of both. As usedherein, “substantially or approximately aligned” refers to a matrix inwhich the fibers show more directional uniformity in any desired planeas compared to a “random” fiber matrix. In an exemplary embodiment ofthis aspect, the scaffold is comprised of a matrix of substantiallyaxially aligned electrospun fibers using a polymer that demonstratespiezoelectric properties. In certain embodiments, the electrospunpiezoelectric polymer is a polyvinyl polymer or co-polymer, for example,a permanently piezoelectric poly (vinylidene fluoride trifluoroethylene)(PVDF-TrFE) copolymer.

In any of the embodiments described herein, the fibers of theelectroactive structure may be thermally annealed prior to seeding withan isolated differentiable stem/progenitor cell. The annealing stepincreases the size of the beta phase crystal in the piezoelectricmaterials, which results in an increase in the piezoelectric property orresulting electrical activity of the material. As described in furtherdetail below, thermal annealing of the matrix fibers results in enhancedpiezoelectric characteristics, and/or improved crystal organization. Theimproved piezoelectric properties of the annealed fibers improvesstem/progenitor cell growth, and/or differentiation. In a preferredembodiment, the fibers are annealed by incubating the scaffold at 135°C. for 96 hours and quenched with ice water prior to seeding with acell. In any of the embodiments described herein, the annealing time canbe varied, however, the annealing step must occur below the meltingtemperature of the material.

In certain additional embodiments, the scaffold demonstrates polarity inone or more planes such as through a gradient in, for example, fiberdiameter, fiber composition, pore size, concentration of chemical orgrowth factor cues or a combination thereof. By varying the polarity ofthe scaffold directional growth or polarized cell growth may beenhanced.

In certain aspects the scaffold matrix, and/or fibers additionallycomprise an exogenous protein or compound to promote cell growth,differentiation, and/or repair, including for example, growth factors,chemokines, polysaccharides, glycans, or the like. In any of theembodiments described herein, the polymer fiber, matrix, and/or scaffoldmay additionally include one or more growth factors. In certainembodiments, the growth factor to be included is capable of enhancing orfurther promoting cell growth and/or differentiation of thedifferentiable stem/progenitor cell into a mature cell phenotype. Forexample, in one exemplary embodiment, the cell to be seeded is anisolated differentiable neuronal progenitor cell, and a suitable growthfactor to be included comprises nerve growth factor (NGF), brain-derivedneurotrophic factor or a combination thereof. In any of the embodimentsdescribed herein, the growth factor may be associated to at least one ofthe polymeric fiber, matrix, and/or scaffold through a covalentinteraction, a non-covalent interaction or a combination of both.

In certain aspects of the invention, the differentiable cell matures ordifferentiates within and/or on the scaffold. The differentiation statusof a cell can be determined by assessing suitable phenotypic markers,e.g., cell surface proteins, and/or gene expression profiles, which arespecific for a differentiated cell. In one embodiment, the mature cellphenotype comprises a neuronal cell phenotype. The mature neuronal cellphenotype is demonstrated by at least one of increased tubulinexpression, reduced expression of nestin, neurite growth or acombination thereof. The mature cell phenotype can be detected using anysuitable method or assay, e.g., immunoglobulin or PCR-based methods,including ELISA, Western Blot, Northern Blot, RTQ-PCR,chemiluminescence/FACS cell sorting or a combination thereof. Suitablemolecular biological and biochemical techniques for assaying for thephenotype of a cell are known in the art and are described in, forexample, Ausubel, et al., CURRENT PROTOCOLS IN MOLECULAR BIOLOGY, JohnWiley & Sons, New York, N.Y., 1993; Sambrook, et al., MOLECULAR CLONING:A LABORATORY MANUAL. 2nd ed., Cold Spring Harbor Laboratory, Cold SpringHarbor Laboratory Press, Cold Spring Harbor, N.Y., 1989.

In an additional aspect, the invention provides the electroactivestructure for growing isolated differentiable cell described hereincomprise a three dimensional matrix of fibers comprising a biocompatiblesynthetic piezoelectric polymeric material, wherein the matrix of fibersis seeded with a combination of at least one isolated differentiablecell and a matrix producing or supporting cell, for example, afibroblast, wherein the structure forms a supporting scaffold forgrowing/differentiating the isolated differentiable cell. In certainembodiments, the isolated differentiable cell is a differentiableneuronal stem/progenitor cell or cell capable of being differentiatedinto a nerve cell. In certain additional embodiments, the matrixproducing or supporting cell to be included comprises a fibroblast, aglial cell, a satellite cell, a Schwann cell or a combination thereof,wherein the combination stimulates differentiation of the isolateddifferentiable neuronal stem/progenitor cell into a mature neuronal cellphenotype on the structure.

The polymeric scaffolds provided by the invention are generated orfabricated in order to more closely mimic the structure of the naturalextracellular matrix in order to promote growth and differentiation ofthe seeded cell and to facilitate transplantation and/or implantation ofthe scaffold or cells grown on the same. For example, experimentalresults have demonstrated for certain exemplary embodiments, enhancedneuronal progenitor cell differentiation and neurite extension onPVDF-TrFe meshes. Also, cells on aligned nanofiber scaffolds extendneurites unidirectionally, parallel with the aligned and/or annealedfibers.

Therefore, in another aspect, described herein are methods for promotingand/or enhancing the growth and/or differentiation of a differentiablestem/progenitor cell, e.g., a neuronal stem/progenitor cell, comprisingseeding a differentiable stem/progenitor cell on a scaffold comprised ofan electrospun polymer that demonstrates piezoelectric properties,wherein the scaffold promotes the growth and/or differentiation of thedifferentiable stem/progenitor cell. In certain embodiments, theelectrospun piezoelectric polymer is a polyvinyl polymer or co-polymer,for example, a permanently piezoelectric poly (vinylidene fluoridetrifluoroethylene) (PVDF-TrFE) copolymer. In certain embodiments, thedifferentiable stem/progenitor cell is a neuronal stem/progenitor cellor cell capable of being differentiated into a mature nerve cell type.In an additional embodiment, the fibers are substantially aligned and/orannealed.

In other aspects, the invention provides a method of making animplantable electroactive scaffold. In an exemplary embodiment, themethod comprises the steps of (a) isolating differentiablestem/progenitor cell from a donor subject; (b) preparing athree-dimensional matrix of fibers formed of a biocompatible syntheticpiezoelectric polymeric material to form a cell scaffold; (c) seedingthe cell scaffold with the isolated differentiable stem/progenitor cell;and (d) growing the differentiable stem/progenitor cell on the cellscaffold so that the differentiable stem/progenitor cell differentiatesinto a mature cell phenotype on the scaffold. In a preferred embodiment,the differentiable stem/progenitor cell is a neuronal stem/progenitorcell or a cell capable of being differentiated into a mature nerve cell,e.g., a peripheral nerve, a CNS or spinal cord nerve. In certainembodiments, the subject is a mammal, for example a human. In anadditional embodiment, the biocompatible synthetic piezoelectricpolymeric material in step (b) is poly(vinylidene fluoridetrifluoroethylene) copolymer. In any embodiment of this aspect, thethree dimensional matrix of fibers may be formed of a biocompatiblesynthetic piezoelectric polymeric material by electrospinning. Furtherstill, in any embodiment described herein, the three dimensional matrixof fibers is a non-woven mesh of nanofibers, microfibers or acombination of both. In still further embodiments, the fibers arealigned and/or annealed.

In another aspect, the invention provides methods of repairing a damagedneuronal cell or tissue in a subject. An exemplary embodiment of thisaspect comprises the steps of (a) isolating at least one differentiablestem/progenitor cell from a donor subject; (b) preparing athree-dimensional matrix of fibers formed of a biocompatible syntheticpiezoelectric polymeric material to form a cell scaffold; (c) seedingthe cell scaffold with the isolated differentiable stem/progenitor cell;(d) growing the isolated differentiable stem/progenitor cell on the cellscaffold ex vivo or in vitro; and (e) implanting the scaffold comprisingthe differentiable stem/progenitor cell at the site of injury, whereinthe differentiable stem/progenitor cell differentiates into a maturecell phenotype on the scaffold. In certain embodiments, thedifferentiable stem/progenitor cell fully differentiates on the scaffoldin vivo.

In a preferred embodiment, the differentiable stem/progenitor cell is aneuronal stem/progenitor cell or a cell capable of being differentiatedinto a mature nerve cell, e.g., a peripheral nerve, a CNS or spinal cordnerve. In certain embodiments, the subject is a mammal, for example ahuman. In an additional embodiment, the biocompatible syntheticpiezoelectric polymeric material in step (b) is poly(vinylidene fluoridetrifluoroethylene) copolymer. In any embodiment of this aspect, thethree dimensional matrix of fibers may be formed of a biocompatiblesynthetic piezoelectric polymeric material by electrospinning. Furtherstill, in any embodiment described herein, the three dimensional matrixof fibers is a non-woven mesh of nanofibers, microfibers or acombination of both. In still further embodiments, the fibers arealigned and/or annealed.

The following examples are put forth so as to provide those of ordinaryskill in the art with a complete disclosure and description of how tomake and use the present invention, and are neither intended to limitthe scope of what the inventors regard as their invention nor theyintended to represent that the experiments below are all or the onlyexperiments performed

EXAMPLES

Materials and methods useful for practicing the present invention may befurther described in one or more of the following: U.S. Pat. Nos.6,689,166; and 6,790,528; and U.S. Published Pat. App. Nos.2004-0018226; 2006-0204539; 2009-0325296; 2009-0028921; and2006-0128012, the disclosures of which are all incorporated herein byreference in their entirety for all purposes.

Example 1 Fabrication of Piezoelectric Tissue Engineering Scaffolds

The present invention makes use of fibers formed from a permanentlypiezoelectric poly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE)copolymer. The PVDF-TrFE copolymer was fabricated into a nanofibrousscaffold using an electrospinning technique.

The electrospinning process is affected by varying the electricpotential, flow rate, solution concentration, capillary-collectordistance, diameter of the needle, and ambient parameters liketemperature. PVDF-TrFE and PLLA were electrospun into fibers accordingto commonly used optimization procedures whereby porosity, surface area,fineness and uniformity, diameter of fibers, and the pattern thicknessof the sheet could be manipulated. See, e.g., Greiner, A. et al AngewChem. Int. Ed. Engl. 46: 5670 (2007).

The electrospinning setup used herein is described in U.S. patentapplication Ser. No. 11/291,701, which is incorporated herein byreference. It is comprised a syringe pump containing a 13-20 gaugeneedle mounted on a robotic arm in order to control the splaying offibers on the collector. An electrically grounded stainless steel plateof dimensions 15×30 cm is used as the collector.

PVDF-TrFE copolymer (65/35) purchased from Solvay Solexis, Inc. (NJ,USA) was dissolved in Methylethylketone (MEK). For the successfulformation of fibers, a 15% w/v solution concentration of the polymer inMEK was used. The syringe pump was filled with the polymer solution, anda constant flow rate of 0.035 ml/min was maintained using the syringepump. The positive output lead of a high voltage power supply (GammaHigh Voltage, Inc.) was attached to a 20 gauge needle, and a 25 kvoltvoltage was applied to the solution. The collector-to-needle distancewas 18.5 cm. The electrospinning process was performed in about 12% toabout 13% humidity at 25 degrees C. When the charge of the polymer atincreasing voltage exceeded the surface tension at the tip of theneedle, the polymer splayed randomly as fibers. These were collected asnonwoven mats on the grounded plate.

Example 2 Characterization of the Electrospun PVDF-TrFE Fibers

Structure and piezoelectric activity of PVDF-TrFE fibers were examinedby differential scanning calorimetry (DSC), thermogravimetric analysis(TGA), thermally stimulated current (TSC) spectroscopy, X-raydiffraction (XRD) and fourier transform infrared spectroscopy (FTIR).Comparisons were made between PVDF-TrFE polymer powder and electrospunPVDF-TrFE fibers.

The fiber diameter of electrospun PVDF-TrFE fibers was characterizedusing Scanning Electron Microscopy (SEM) according to establishedmethods and compared to poly L-lactic acid (PLLA) meshes. FIG. 1 showsthat the resulting fibrous meshes had an average fiber diameter of970±480 nm, with uniform fiber morphologies having no beading, ascharacterized by scanning electron microscopy. The fiber mats were freeof droplets.

Thermally stimulated current (TSC) spectroscopy is widely used tounderstand dielectric relaxation in complex solid systems. TSC is basedon the ability of polar molecules to be moved by an electric staticfield. At a temperature Tp, an electric field is applied during a timetp long enough to let the dipoles orient themselves. This configurationis fixed by a rapid decrease in temperature to reach a temperature T0.At T0, the sample is short-circuited during a time t0 to remove thespace charges and to equilibrate the temperature. The progressive andsequential release of the entities oriented previously can be observedduring a linear rise in temperature. The depolarization current is thenrecorded as a function of the temperature.

TSC measurements confirmed that the electrospun PVDF-TrFE fiberscaffolds have internal charges comparable to the original piezoelectricpolymer powder. The electrospun and powder forms were heated from −60°C. to 140° C. (7 C per min) and were subjected to an externally appliedfield of 100 V. FIG. 2 shows the data resulting from TSC analysis of theelectrospun PVDF-TrFE mat and the non-processed powder form. It showsthat for both the powder and electrospun forms, there was polarizationdue to the applied electric field followed by a spontaneous relaxation.

Thermal Gravimetric Analysis (TGA) was performed to detect any remainingsolvent in the nanofiber mat using a Thermal Gravimetric Analyzer (TAInstrument model Q50). The analyzer measures weight changes in materialswith regard to temperature, which allows for the effective quantitativeanalysis of thermal reactions that are accompanied by mass changesresulting from dehydration, decomposition and oxidation of a sample.

The nanofiber mat was subjected to vacuum prior to the analysis. Asample of the test material was placed into a high alumina cup supportedon, or suspended from, an analytical balance located outside the furnacechamber. The balance was zeroed, and the sample cup heated according toa predetermined thermal cycle. The balance sends the weight signal tothe computer for storage, along with the sample temperature and theelapsed time. The TGA curve plots the TGA signal, converted to percentweight change, on the Y-axis against the reference material temperatureon the X-axis.

The results showed that fibrous meshes with vacuum treatment had a 0.5%solvent content as demonstrated by a loss of 0.5 weight percent ascompared to the unprocessed/raw polymer.

Results obtained by DSC, XRD and FTIR showed that the electrospinningprocess did not alter significantly the polymer structure compared tothe original piezoelectric polymer powder.

Differential scanning calorimetry (DSC) is used to study the thermalbehavior of polymers. In this technique, separate chambers for thesample and reference are heated equally. Transformations taking place inthe sample are detected by the instrument, which compensates by changingthe heat input so that there is a zero temperature difference betweenthe reference and sample. The amount of electrical energy supplied tothe heating elements is then proportional to the heat released by thesample. Thermal analysis was performed with a TA Model Q100 DifferentialScanning calorimeter.

Fourier-Transform Infrared Spectroscopy (FTIR) is used to observevibrational changes in chemical bonds. Here, infrared radiation in therange from 4000 to 600 cm⁻¹, the mid-infrared region, was used. Thepresence and intensity of specific vibrational frequencies allows fordetermination of functional groups in organic molecules. The class ofmaterial (proteinaceous, cellulosic, and so forth) then can beidentified from these functional groups.

A micro x-ray diffractometer capable of focusing a collimated x-ray beam(20 to 800 micron diameter range) onto areas of interest within thesample was used to generate an x-ray diffraction (XRD) patterncharacteristic for the crystalline phases contained within the sample.X-rays diffracted by the sample strike a detector and are converted toan electronic signal that is then further processed by software.Search-match software then was used to match the unknown diffractionpattern to a database of diffraction patterns collected from referencecompounds.

The degree of crystallinity was determined, and the piezoelectriccrystal form of the copolymer present in the electrospun PVDF-TrFE matswas confirmed, by DSC. Comparisons of PVDF-TrFE mats with thepiezoelectric unprocessed powder and solvent-cast film as well as withnonpiezoelectric-unpoled PVDF pellets were made.

TABLE 1 Comparison of DSC data with literature values PVDF-TrFEPVDF-TrFE PVDF-TrFE PVDF (65/35) (65/35) (65/35) Physical form PelletPowder Solvent-cast film Electrospun fiber Tm(C) 171 (161*) 107 (1 peak)115 (1 peak) 115 (1 peak) 147 (154.55**) (2 peak) 147 (2 peak) 149 (2peak) ΔHf(J/g)  45 (50*)  13 (1 peak)  13 (1 peak)  15 (1 peak)  23(30**) (2 peak)  34 (2 peak)  28 (2 peak) *Zhao, Z. et al., J. Appl.Polym. Sci. 97: 466-74 (2005); **Data provided by supplier (SolvaySolexis, Inc.)

Table 1, which compares the experimental DSC data with literature valuesfor test polymers (in parentheses), shows that low and high temperaturepeaks were observed in the PVDF-TrFE polymer during the first and secondheating cycle. The differences in the first heating cycle between thetest polymers were not detectable in the second heating cycle, whichsuggests that there is no chemical degradation or changes in thechemical structure due to the fabrication process. The melting pointsand heats of fusion for PVDF-TrFE materials are distinct from valuesobtained for the unpoled PVDF pellet, indicating that the piezoelectricbeta-phase crystal form is present in the electrospun mat.

Moreover, the electrospun electroactive PVDF-TrFE fibers of the presentinvention do not require poling to show a piezoelectric effect. The term“poling” as used herein refers to the adjustment of the polarity of asubstance. For example, electric dipoles may be aligned (meaningarranged, positioned or synchronized in a manner that allows for properor optimal functioning) by utilizing an electric field. In this content,the term “polarity” refers to the property, state or condition of havingor manifesting two opposite or opposing charges within the same body(versus, e.g., cellular polarity, which refers to a situation in which acell has two or more anatomically and/or functionally distinct cellulardomains).

Example 3 PVDF-TrFE Fiber Mats Support Stem Cells

Three studies were conducted to establish that the PVDF-TrFE fiber meshcan be used as a scaffold to support stem cells or other cell types.

Materials and Methods

Cells.

(a) Cell line model for neuronal differentiation. When treated withnerve growth factor (NGF), PC12 cells, a cell line derived from apheochromocytoma of the rat adrenal medulla, stop dividing, grow longneurites, and undergo terminal differentiation, which makes this cellline a useful model system for neuronal differentiation.

PC12 cells (ATCC number CRL-1721) were seeded at 3×10³ cells per cm²culture dish and maintained in ATCC formulated F-12K medium containing1.5% fetal bovine serum and 15% horse serum. Cultures were maintained at37° C., 95% air, 5% CO₂ atmosphere. For induction of the neuronalphenotype, 50 ng/ml NGF (Chemicon) was added to the medium at the startof the culture and maintained throughout the duration of the culture.The term “induction media” refers to the medium containing NGF.

(b) Fibroblasts. Normal human skin fibroblasts (ATCC number SCRC-1041)were seeded at 5×10³ cells per cm² culture dish and maintained inDulbecco's modified Eagle's medium containing 15% fetal bovine serum.

(c) Mesenchymal stem cells. Human mesenchymal stem cells (hMSCs) wereprepared as described in Livingston, et al., J. Materials Science:Materials in Med. 14: 211-218 (2003) and in U.S. Pat. No. 5,486,359,which are incorporated herein by reference. In brief, bone marrowaspirates of 30-50 mL were obtained from healthy human donors. Marrowsamples were washed with saline and centrifuged over a density cushionof ficoll. The interface layer was removed, washed, and the cellscounted. Nucleated cells recovered from the density separation werewashed and plated in tissue culture flasks in Dulbecco's ModifiedEagle's Medium (DMEM) containing 10% fetal bovine serum (“FBS”, HyCloneLaboratories, Inc.). Non-adherent cells were washed from the cultureduring biweekly feedings. Colony formation was monitored for a 14-17 dayperiod. MSC's were passaged when the tissue culture flasks were nearconfluent. At the end of the first passage, MSCs were enzymaticallyremoved from the culture flask using trypsin-EDTA and replated at alower density for further expansion. At the end of the second passage,MSC's were either seeded onto scaffolds or cryopreserved until futureuse. The hMSC cells were identified as multipotent stem cells based onsurface marker characterization, which distinguishes the stem cells fromother cell types in the bone marrow, for example white blood cells.Cells expressing CD44 (CD44+) and the absence of CD45 (CD45−) and CD34(CD34−) surface antigens were verified byfluorescence-activated-cell-sorter.

Chondrogenic Differentiation.

Chondrogenic differentiation of hMSCs was performed according topublished procedures. See Barry, F. et al., Exp. Cell Res. 268, 189(2001), which is incorporated herein by reference. 2×10⁵ cells wereseeded on PVDF-TrFE scaffolds in 24-well plates using three differentculture media: (i) the chondrogenic culture media containing TGFβ3, orinduction media, (CCM+), consisted of 1 mM sodium pyruvate (Sigma), 0.1mM ascorbic acid-2-phosphate (Wako), 1×10⁻⁷ M dexamethasone (Sigma), 1%ITS 1 (Collaborative Biomedical Products), and 10 ng/ml recombinanthuman TGFβ3 (Oncogene Sciences) dissolved in Dulbecco's Modified Eagle'sMedium containing 4-5 g/L glucose (DMEM-LG), (ii) chondrogenic culturemedia (CCM) without TGFβ3 (CCM−); (iii) mesenchymal stem cell growthmedia (MSCGM), the standard growth media for hMSCs, consisting ofDMEM-LG with 10% fetal bovine serum and 1% antibiotic-antimycotic. Cellswere harvested after 1, 14, and 28 days of culture.

Cell pellet cultures served as controls for these experiments. A singlecell pellet was produced by centrifuging 2.5×10⁵ cells in a 15 mLcentrifuge tube and culturing the pelleted cells in the tube.

Cell Viability.

Metabolic activity and cell growth were measured using the XTT kit(Biotium, USA). XTT is a tetrazolium derivative that measures cellviability based on the activity of mitochondria enzymes in live cellsthat reduce XTT and are inactivated shortly after cell death. XTT isreduced to a highly water-soluble orange colored product, the amount ofwhich is proportional to the number of living cells in the sample, andcan be quantified by measuring absorbance at wavelength of 475 nm.

Cells were plated onto scaffolds in 96-well tissue culture plates at10,000 cells per well for up to 7 days. Reagents were added such thatthe final volume of tissue culture medium (containing 10% FBS) in eachwell was 0.1 ml. For one 96-well plate, 25 μl Activation Reagent wasmixed with 5 ml XTT Solution to derive activated XTT solution. 25 μl or50 μl of the activated XTT solution was added to each well and the plateincubated in an incubator for 4 hours. The plate was shaken gently toevenly distribute the dye in the wells. The absorbance of the sampleswas measured spectrophotometrically at a wavelength of 450-500 nm.Reference absorbance is measured at a wavelength of 630-690 nm.

Real Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR).

RNA was isolated using a Qiagen Mini kit (Qiagen). Samples were lysedand then homogenized using QiaShredder columns (Qiagen). Ethanol wasadded to the lysate and the lysate was loaded onto the RNeasy silica-gelmembrane. Pure, concentrated RNA then was eluted from the membrane inwater.

Gene Expression Markers.

Relative gene expression analysis (QuantiTect SYBR Green RT-PCR kit,Qiagen) for chondrogenic markers (chondroadherin, type II collagen), andfocal adhesion kinase (FAK) was performed using the MX4000 detectionsystem (Stratagene). Ribosomal protein, large, PO (“RPLPO”) was used ashousekeeping gene.

Qiagen PCR Kit.

2× QuantiTect SYBR Green RT-PCR Master Mix (stored at −20° C.), templateRNA, primers, and RNase-free water were thawed, mixed individually andplaced on ice. A reaction components master mix was prepared as follows:

Component Volume/reaction Final concentration 2x QuantiTect SYBR Green12.5 μl 1x RT-PCR Master Mix Primer A Variable 0.5-2.0 μM Primer BVariable 0.5-2.0 μM QuantiTect RT Mix 0.25 μl 0.25 μl RNAse-free waterVariable — Optional: Uracil-N-glyeolase, Variable 1-2 units/reactionheat labile Template RNA Variable ≦500 ng/reaction Total volume   25 μl

Where final reaction volumes other than 25 μl were used, the volumes of2.times. Quanti-Tect SYBR Green RT-PCR Master Mix and Quanti Tect RT Mixused were adjusted so that the ratio between them remained constant.

The master mix was mixed thoroughly and appropriate volumes dispensedinto PCR tubes. Template RNA (≦500 ng/reaction) was added to theindividual PCR tubes and incubated on ice for less than 30 min. TheMX4000 was programmed and data acquisition performed during theextension step. A melting curve analysis of the RT-PCR product(s)between 55° C. and 95° C. was performed to verify specificity andidentify of the RT-PCR products.

A standard curve was generated using various RNA concentrations, whichcontain substantial levels of chondrogenic markers (chondroadherin, typeII collagen) and focal adhesion kinase (FAK). Two optical channels, onefor SYBR Green and one for a reference dye (ROX), were used to correctfor volume and plate location differences. Each template was analyzed intriplicate. Stratagene reaction tubes (Cat. No. 41002) and caps (Cat.No. 410024) were used, and fluorescence data was collected for SYBRGreen. A typical thermal profile used was the following: 50° C. for 30min (reverse transcriptase step), 95° C. for 15 min (to activate the DNApolymerase), 40 cycles of: 94° C. for 15 sec, 55° C. for 30 sec, 72° C.for 30 sec (triplicate readings of fluorescence were taken during thisphase of the cycle.)

A dissociation curve was generated after the amplification cycles werecompleted. For the amplification plots, fluorescence was analyzed as“dRn” to generate C.sub.t values for all of the samples simultaneously.Gene expression levels were analyzed according to Mueller (Mueller, P.Y., Janoviak, H., Miserez, A. R., Dobbie, Z., Biotechniques 32, 1372-74(2002)), which is incorporated herein by reference, and expressed as“mean normalized expression.”

Confocal Microscopy.

Confocal fluorescence microscopy was used to obtain fluorescence imagesof cells cultured on fiber scaffolds. A fluorescent stain, whichvisualizes nuclear DNA (4′,6-diamidino-2-phenylindole, DAPI, Invitrogen,USA) and the actin cytoskeleton (Alexa Fluor 488 phalloidin; Invitrogen,USA) in fixed cells was used. Fluorescence images of cells cultured onfiber scaffolds were taken with a confocal fluorescence microscope(Clsi, Nikon, Japan).

Cell Proliferation.

Cell number over time was measured using the PicoGreen assay(Invitrogen).

sGAG Synthesis.

Absorbance at 656 nm was used to measure total sulfated proteoglycancontent (“sGAG”) using the Blycan assay (Biodyne Science, UK).

Results

The results show that PDVF-TrFE fiber piezoelectric scaffolds arebiocompatible and stimulate differentiation of hMSCs into chondrocytes,PC-12 neuronal cells into neurites; and stimulate attachment and growthof fibroblasts on the PVDF-TrFE scaffold as compared to growth of thesecells under normal culture conditions.

FIGS. 3a-3c shows that at 10 days in culture, extensive neuriteextension on PVDF-TrFE meshes was seen with or without media containingNerve Growth Factor (NGF). Neurite extension of cells grown on electrospun poly-L-lactic acid [PLLA] (average fiber diameter of 1.0±0.4 μm)scaffolds appeared less extensive and only occurred in the presence ofNGF. As shown in FIG. 5d , cell growth, as measured by metabolicactivity using the XTT kit (Biotium, USA), was significantly lower onPVDF-TrFE meshes for both growth and induction media as compared totissue culture polystyrene and PLLA scaffolds, suggesting that PVDF-TrFEdownregulates proliferation and facilitates differentiation.

FIGS. 4 and 5 shows that for human mesenchymal stem cell chondrogenesis,glycosaminoglycan production by cells on PVDF-TrFE meshes/mats wassignificantly higher than for cells on PLLA or in pellet culture(positive control) in inductive media. It is known that transforminggrowth factor β (TGF-β) induces chondrogenesis in hMSCs and involvesdeposition of a cartilage-specific extracellular matrix. Barry, F. etal., Exp. Cell Res. 268, 189 (2001). Initial studies showed thatchondrogenic markers and sGAG synthesis was significantly induced byCCM+ media. As shown in FIG. 4, the sGAG concentrations andchondroadherin/FAK gene expression was significantly higher on PVDF-TrFEas compared to PLLA scaffolds (p<0.01). However, no significantdifferences between PVDF-TrFE and PLLA scaffolds could be seen usingCCM− and MSCGM media (chondroadherin, type II collagen, and FAK geneexpression; sGAG synthesis).

Human skin fibroblasts (ATCC number SCRC-1041) were cultured onPVDF-TrFE fiber scaffolds over a 7-day period. Tissue culturepolystyrene (TCPS) served as the control). FIG. 6 and FIG. 7 show thatfibroblasts grew and were well-spread on PVDF-TrFE meshes. This wascomparable to growth on tissue culture plastic (positive control).

Confocal fluorescence microscopy verified the attachment andproliferation of the cells on the PVDF-TrFE fiber scaffolds. FIG. 7shows confocal scanning laser microscopy images of human skinfibroblasts attached to PVDF-TrFE fibers after 1 day and after 7 days ofcell culture. The cell morphologies of one day cultures on the fiberscaffolds are distinctly different from those of 7-day cultures. On day1, the cells are not fully spread out. When grown on the scaffolds for alonger time (7 days) cells exhibit a more elongated and spread-outmorphology.

Example 4 PC12 and DRG Culture

For one embodiment of the present invention the scaffolds werepre-conditioned in cell culture media for one day prior to seeding. PC12cells were seeded at 0.18×10⁶ cells/cm² on to the scaffolds and collagencoated plates (control) and were cultured in either control media orinduction media containing neural growth factor (NGF, 250 ng/mL) a dayafter. PC12 cells were stained with Phalloidin (cytoskeletal stain,Invitrogen) and proliferation was evaluated by MTT cell proliferationassay (Invitrogen) at day 10 and 14.

In an exemplary embodiment of the present invention, DRGs isolated fromE15 embryonic rat pup were plated on the scaffolds and stained withVybrant® CFDA SE cell tracker (Invitrogen, Carlsbad, Calif.) at day 3.

Average fiber diameter in this exemplary embodiment of electrospunPVDF-TrFE was 0.75 μm±0.08. Directional fiber orientation was observedin the aligned scaffolds (FIG. 1). Crystallization (data not shown) andmelting point of electrospun PVDF-TrFE (148.1° C.) were shifted to ahigher temperature as compared to the unprocessed powder (146.1° C.)(FIG. 2). Current movement occurred just before melting in theunprocessed powder (FIG. 2a ). Current movement started at 65° C. andcontinued before the melting in temperature of electrospun PVDF-TrFE(FIG. 2b ). The 35° C. peak is the spontaneous relaxation of the Teflonsheets. When the mechanical deformation started, an increase in electricresponse occurred (FIG. 2c ). Amplitude of response varied between −30mV to 30 mV (FIG. 2d ) for this embodiment of the present invention.

PC12 neurite extension was observed on both random and aligned scaffolds(FIG. 8b,d ). Neurite extension both occurred along the direction ofalignment (FIG. 8d ) and on the collagen coated plates (FIG. 8f ). PC12proliferation was higher on collagen in the induction group on both days10 and 14 (FIG. 8g ). Proliferation in the control media was similar forboth materials at both time points (data not shown). Neurite extensionof DRGs was also observed on both random and aligned PVDF-TrFE scaffolds(FIG. 9).

In certain exemplary embodiments of the present invention, DSC resultsof unprocessed and electrospun PVDF-TrFE indicated no significantalternation occurred during the electrospinning process, as indicated bysimilar melting temperatures. Shifting of melting and crystallizationtemperature suggested extended chain crystallization during theelectrospinning process. The piezoelectric phenomenon is characterizedby the presence of dipole crystal structure. For certain embodiments,dipole movement would occur upon heating and could be observed as thecurrent movement on TSDC. DSC and TSDC results of electrospun PVDF-TrFE(FIG. 2b ) suggested a phase transform allowing dipole movement. Crystalstructure movement upon melting contributed to the current movement inthe unprocessed PVDF-TrFE powder (FIG. 2a ). The electrical activitydetected in these embodiments while deforming the electrospun PVDF-TrFE(FIG. 2c,d ) corresponded to the observation of its piezoelectricproperties.

PC12 cell proliferated and extended neurites along the direction offiber alignment indicated the influence of contact guidance. Nodifference in cell proliferation was observed in control media on bothdays suggesting it may due to the differentiation process.

Neurite extension of both PC12 cells and DRGs was observed on bothrandom and aligned electrospun PVDF-TrFE scaffolds, suggesting itsutility as a scaffold for spinal cord repair. The piezoelectricscaffolds can be implanted in contusion or transection spinal cordinjury (SCI) models (FIG. 10). We are currently evaluating the scaffoldseven days after contusion injury to evaluate the effect of thisintervention. The contusion injury model in rats is routinely used tomimic human SCI. (21) A 200 kilodyne (kd) (1 dyne=10 uN) contusionspinal cord injury can be inducted using an infinite horizon impactor.At one week post-injury, the spinal cords will be re-exposed in allanimals and scaffold constructs will be inserted into the contused areaof the cords. Functional recovery can be evaluated histologically and bymotor and sensory function.

Example 5 Evaluation of Neural Differentiation of Human NeuralStem/Progenitor Cells on Piezoelectric Scaffolds (with Reference toFIGS. 11 and 12)

This study investigates the neural differentiation of human neuralstem/progenitor cells (hNPCs) on fibrous, PVDF-TrFE to determine itspotential use as a scaffold in nerve repair. The piezoelectricproperties of PVDF-TrFE were enhanced by annealing to increase crystalorganization. Comparisons were made with laminin coated tissue cultureplastic (control).

Scaffold Fabrication (Electrospinning):

Polymer solutions for electrospinning were prepared with PVDF-TrFE inmethyl-ethyl-ketone (MEK) Random and aligned electrospun scaffolds werecollected on a plate and a rotating drum, respectively. Annealed sampleswere kept at 135° C. for 96 hours and quenched with ice water.

Characterization of Thermal and Piezoelectric Properties Evaluation.

Scanning electron microscopy (SEM) images were taken to evaluate thefiber diameter and orientation. Differential scanning calorimetry (DSC)was used to evaluate thermally active transition such as meltingtemperature. X-ray diffraction (XRD) was performed to evaluate crystalstructure of as-spun and annealed PVDF-TrFE. Thermally-stimulatedcurrent (TSC) was used to confirm piezoelectricity by measuring thecurrent indicating the dipole movement in response to an increase intemperature. In exemplary embodiments, thermal and piezoelectricproperties were evaluated using differential scanning calorimetry (DSC)and thermal stimulated depolarization current (TSDC) on both unprocessedpowder and electrospun PVDF-TrFE. A heat-cool-heat cycle from −60° C. to200° C. with heating and cooling ramp of 7° C./min was used on DSC toevaluate thermally active transition such as crystallization, melting,and phase transition. Electrospun PVDF-TrFE or the powder was sandwichedbetween the two Teflon films and heated from −60° C. to 140° C. for TSDCexperiments [6].

Electric Response.

Electrodes (10 mm×10 mm) were attached to the ends of the scaffold usingsilver conductive epoxy for one embodiment of the present invention. Thescaffold of this inventive embodiment was mechanically deformed at therate of 10 mm/min using Instron. The electrodes were then connected to acustom-made amplifier circuit and the signals were recorded usingMatlab.

In Vitro Study:

hNPCs (Lonza), which are cryopreserved neurospheres obtained from fetalbrain tissue (20 weeks), were seeded at 45,000 cells/cm² and cultured indifferentiation media (Lonza) with 25 ng/mL brain-derived neurotrophicfactor (BDNF) or standard growth media for 9 days. Comparisons were madewith laminin coated plates. The cells were fixed and stained withanti-Nestin (NPCs), glial fibrillary acidic protein (GFAP) (astrocytes),and neuron-specific beta-III tubulin (neuron), followed by DAPI ascounter stain. 4 images were taken for each sample (n=6 per group) andpositive stain was manually counted to obtain percentage ofdifferentiation. One-way analysis of variance (ANOVA) and Tukey-Kramertest were used to determined the statistic significance between thegroups (p<0.05).

Results.

The average fiber diameter of micron-(L) and sub-micron-(S) PVDF-TrFEwere 3.32±0.2 μm and 0.75±0.08 μm, respectively. The melting point ofas-spun of PVDF-TrFE (L) and (S) increased from 147.9° C. and 147.8° C.to 152.4° C. and 154.5° C. after annealing, respectively. The increasein melting temperature suggested an increase in crystallinity due toannealing. XRD results indicated an increase in the intensity of thepiezoelectric beta phase at 20.4° and the loss of the non-piezoelectricalpha phase around 18.5° on the annealed in comparison to the as-spunsamples. The annealing process induced crystal organization hence,enhancing the piezoelectric properties.

This study demonstrates the potential for using an electroactivescaffold as described herein for nervous tissue repair. The scaffoldsenhanced neural differentiation, as indicated by a lower level of nestinpositive cells on scaffolds in comparison to laminin surfaces. Neuronaldifferentiation may be enhanced on annealed scaffolds, which displayhigher piezoelectricity, as indicated by the higher fraction of cellsexpressing beta-III tubulin.

Example 6 Use of Electrospun PVDF as Scaffold for Bone TissueEngineering (in Connection with FIGS. 13-19)

In this study, PVDF scaffolds were prepared by electrospinning atdifferent voltages (12-30 kV), evaluated for the presence of thepiezoelectric beta-crystal phase and its effect on biological function.Electrospun PVDF was compared with unprocessed/raw PVDF, film andmeltspun fibers for the presence of the piezoelectric beta-phase usingDifferential Scanning calorimetry (DSC), Fourier Transform InfraredSpectroscopy (FTIR) and X-Ray Diffraction (XRD).

The cytocompatibility and osteogenic differentiation potential of humanmesenchymal stem cells (MSCs) was evaluated on scaffolds electrospun at12 and 25 kV (PVDF-12 kV and PVDF-25 kV, respectively) and compared totissue culture polystyrene (TCP). Electro spinning PVDF resulted in theformation of the piezoelectric beta-phase with the highest beta-phasefraction of 72% for electrospun PVDF at 25 kV. MSCs cultured on both thescaffolds and TCP had normal morphology and were well spread. The MSCsseeded on PVDF-25 kV scaffolds had the greatest alkaline phosphataseactivity and mineralization by day 10 when compared to TCP and PVDF-12kV. The results demonstrate the potential for the use of PVDF scaffoldsfor bone tissue engineering applications.

In particular, this MSC cell study showed the osteogenic differentiationof human MSCs on both mats (i.e., the low- and high-voltage electro spunmats) was enhanced, as determined by mineralization and alkalinephosphatase activity, in comparison to cells on tissue culturepolystyrene.

Introduction

In bone tissue engineering, it is desirable to have a scaffold which isosteoconductive and osteoinductive. A scaffold is consideredosteoconductive if it provides a three-dimensional matrix with adequatepore size, porosity, and a surface that allows for cells to attach,proliferate and form bone tissue¹. The electrospinning process has beenwidely applied for the development of scaffolds for tissue engineeringapplications². In electrospinning process, a high electric field isapplied to a polymer solution resulting in the formation of a chargedjet, which is later collected as a non-woven continuous fiber on agrounded plate. Electrospun scaffolds can mimic the fibrous architectureof the natural extracellular matrix and a provide large surface area,which has been shown to directly influence cell attachment and proteinadsorption for various tissue engineering applications². The scaffoldproperties such as porosity and fiber size can be tailored dependingupon polymer concentration and spinning conditions.

The osteoinductive property in a scaffold induces the differentiation ofmesenchymal stem cells towards the osteogenic lineage, which may beachieved by means of physical stimuli or delivery of bioactivemolecules¹. Piezoelectric polymers are intriguing due to its capabilityof generating transient surface charges under minute mechanicaldeformation, which may influence cell behavior³. A commonly usedpiezoelectric polymer is Poly (vinylidene) fluoride (PVDF)⁴⁻⁶. PVDF is asemi-crystalline polymer that can exist in at least four polymorphs α,β, γ and δ of which α and β re of great interest. The α-phase is mostreadily formed during crystallization from melt below 160° C. Its chainconformation is arranged in trans-gauche-trans-gauche (TG+TG−), wherenet dipole moment is zero due to its antiparallel arrangement offluoride atoms along the carbon backbone, and as a result, is thenon-piezoelectric form^(6,7). The β-phase can be formed by mechanicalstretching of α-phase and is also the piezoelectric form. Its chains arearranged in a planar all-trans (TTTT) conformation resulting in a largedipole moment^(7,8). Among these polymorphs, β-phase is the most soughtafter due to its superior piezoelectric and pyroelectric propertieshence may have potential osteoinductive properties for bone tissueengineering applications.

Previous studies have primarily used PVDF films for demonstrating theinfluence of the piezoelectric property on cell behavior. It has alsobeen shown that poled PVDF substrates influence endothelial cells tosecrete anti-thrombotic proteins. Nevertheless, these studies wereprimarily performed using films or substrates. However, athree-dimensional environment is essential to facilitate spatialdistribution of cells, which can later organize into bone tissueresembling in vivo bone^(2,3).

In the current study, PVDF scaffolds were prepared by using a similarpolar solvent, dimethylacetamide and acetone. This study demonstratesfor the first time the influence of electrospinning PVDF at variousvoltages on the formation of β-phase and comparing the resulting crystalstructures to PVDF film and melt spun fibers. In addition, this studyshows for the first time the osteogenic differentiation of humanmesenchymal stem cells (MSCs) on these electrospun PVDF scaffoldsprocessed using different voltages and examines the effect of thevoltage variations on cell behavior.

Materials and Methods

PVDF.

Poly (vinylidene fluoride) (PVDF) pellets (M.W. 275000),N,N-Dimethylacetamide (DMAC) and acetone were supplied by Sigma Aldrich,St. Louis, Mo. (USA).

Scaffold Fabrication by Electrospinning

20 wt. % PVDF/DMAC-acetone (1:1 by volume) solutions were prepared at50° C. and stored at room temperature overnight prior toelectrospinning. The PVDF solution was placed in a plastic syringefitted with 18 g needle (Harvard Apparatus, MA, USA). A syringe pump(Harvard Apparatus, MA, USA) was used to feed the solution into theneedle at a fixed flow rate of 0.5 ml/h. A high voltage power supply(Gamma High Voltage, FL, USA) was used to produce different voltagesranging from 12-30 kV. The electrospun fibers were collected on agrounded aluminum plate placed at a distance of 20 cm from the tip ofthe needle. The scaffolds were placed under vacuum for 48 hours toremove organic solvents.

Melt Spun PVDF Fibers Fabrication

PVDF was meltspun into monofilament fibers from a capillary rheometer(Instron 3211, USA) consisting of a capillary die with a diameter of0.254 mm. Fibers were melt spun at 230° C., 240° C., 260° C., 280° C.and 290° C. at a piston speed of 2 mm/min. They were spun through air atroom temperature to a take-up wheel speed of 15 m/min. After spinning,the fibers were transferred from the take-up wheel to a small bobbin.

Film Fabrication

PVDF pellets (density: 1.78 g/cm³) were placed within a circular moldwith approximate volume of 5 cm³. The mold was then placed betweenpreheated flat plates (280° C.) of a hydraulic press (Carver 3912, USA),which was compressed, and then cooled to form a thin film with anapproximate diameter of 9.5 cm with 0.1 cm depth.

Scanning Electron Microscopy

Scanning electron microscopy (SEM, LEO 1530 Gemini, Germany) was used toevaluate the fiber morphology and average fiber diameter of thescaffolds. Mats (n of 3 per scaffold type) were sputter coated with goldpalladium and viewed using an accelerating voltage of 5-10 kV and aworking distance of 2 to 5 cm. Image J software (National Institutes ofHealth, MD, USA) was used to determine fiber size from SEM images usingpreviously reported protocols⁴.

Fourier Transform Infrared Spectroscopy

Fourier transform infrared (FTIR) analysis was performed for PVDFpellets, melt spun fibers and electrospun scaffolds (Perkin ElmerFTIR-ATR 100 series, MA, USA), and the data presented are representativeof three independent samples and runs. The samples were scanned from 400to 1500 cm⁻¹ with a resolution of 4 cm⁻¹ and total of 40 scans.

Previously described procedures were used to determine the relativefraction of β-phase present in each sample⁹⁻¹¹. Using characteristicabsorption bands of α and β phases at 531 cm⁻¹ and 840 cm⁻¹,respectively, and assuming that these absorption bands followBeer-Lambert law with absorption coefficients of K_(α)=6.1×10⁴ andK_(β)=7.7×10⁴ cm²/mol, the fraction of β-phase can be calculated usingthe following equation (1): where X_(α) and X_(β) are the crystallinemass fractions of the α and β phases and A_(α) and A_(β) correspond toabsorption bands at 531 cm⁻¹ and 840 cm⁻¹, respectively.

$\begin{matrix}{{F(\beta)} = {\frac{X_{\beta}}{X_{\alpha} + X_{\beta}} = \frac{A_{\beta}}{{1.26\; A_{\alpha}} + A_{\beta}}}} & (1)\end{matrix}$

Differential Scanning Calorimetry

Differential scanning calorimetry (DSC; TA Q100, DE, USA) was used todetermine the melting temperature (T_(m)) and Heat of Fusion (ΔH_(f)) ofall samples and compared with unprocessed PVDF pellet. The samplesunderwent a heat-cool-heat temperature cycle program with a heating andcooling rate of 10° C./minute from −70° C. to +250° C. under nitrogenpurge. The DSC data presented were representative of six independentruns. The crystallinity (X_(c)) of samples was calculated using thefollowing relation: where, H_(fs) is the measured heat of fusion formelting of sample, and H_(ft) is the heat of fusion for 100% crystallinePVDF. H_(ft) was assumed to be 104.7 Jg⁻¹ ¹².

$\begin{matrix}{{X_{c}(\%)} = {\frac{H_{fs}}{H_{ft}} \times 100}} & (2)\end{matrix}$

X-Ray Diffraction

X-ray diffraction (XRD) of all the samples was recorded on an X'pert ProDiffractrometer (Philips PW3050/60, Netherlands). The samples wereirradiated with monochromatized Cu Kα (λ=0.154 nm) X-ray source with astep size [2θ] of 0.02 and scan step time [s] of 1.0. The operatingvoltage and current used were 45 kV and 40 mA, respectively. The sampleswere scanned in the 2-theta range of 15 to 45 degrees.

In Vitro Cell Study

Human mesenchymal stem cells (MSCs) were isolated from commerciallyavailable whole bone marrow aspirates (Cambrex, Md., USA)¹³. Theisolation method followed has been previously reported^(13,14). The MSCswere plated on tissue culture polystyrene flasks (Nunc, N.Y., USA) andmaintained at 37° C. and 5% CO₂ in control medium consisting ofDulbecco's Minimum Essential Medium (DMEM; Invitrogen, USA) supplementedwith 10% fetal bovine serum (Hyclone, Utah, USA), and 1%antibiotic-antimycotic (Invitrogen). The cells were harvested at 70-80%confluency and resuspended in control medium for cell seeding. PVDFscaffolds electro spun at 12 KV (PVDF-12 kV) and 25 KV (PVDF-25 kV) werecut into 6 mm diameter disks using a biopsy punch (Miltek, USA). Thescaffolds were sterilized with 100% ethanol (Fisher Scientific, USA) for20 mins and later rinsed four times with PBS. Prior to cell seeding,scaffolds were transferred to a non-adherent, 96-well polypropyleneplate (Fisher Scientific). MSCs were seeded at 3×10⁴ cells/cm² on thescaffolds and tissue culture polystyrene served as a control. The cellswere cultured either in control medium or osteoinduction (OS) media. OSmedium consisted of control medium supplemented with 10 mMbeta-glycerophosphate (Sigma Aldrich), 50 μM L-ascorbic acid phosphate(Wako, Va., USA) and 100 nM of dexamethasone (Sigma Aldrich). Cells wereharvested at days 7, 10, 14, and 21 for proliferation anddifferentiation assays.

Cell Proliferation

Cell proliferation was determined by DNA quantification using thePicoGreen® ds DNA assay (Invitrogen). Standards were prepared with aknown number of MSCs. Standards and samples (n=5 per group per timepoint) were lysed with 0.1% Triton X-100 (Sigma Aldrich). An aliquot ofcell lysate was mixed with an equal volume of diluted PicoGreen reagentin 1× TE buffer (1:200, Invitrogen). Fluorescent intensity was measuredwith a microplate reader (FLX800, Biotek Instruments, VT, USA.) at 480nm excitation and 520 nm emission. Fluorescent intensity was correlatedto cell number using a standard curve.

Alkaline Phosphatase Activity

Alkaline phosphatase (ALK) activity was measured by quantifying theconversion of para-nitrophenyl phosphate (Sigma Aldrich) topara-nitrophenol (p-NP). Samples (n=5 per group per time point) wereprepared by lysing cells with 0.1% Titon X-100 and incubated at 37° C.for 30 minutes. The absorbance was read at 405 nm with a microplatespectrophotometer (Emax, Molecular Devices, CA, USA). The ALK activitywas normalized to cell number and expressed as nmol of p-Np/min/cell.

Mineralization Assay

Mineralization of the extracellular matrix was measured using a calciumdetection kit (Fisher Scientific). Briefly, 0.5 N HCl was added to thesamples (n=5 per group per time point). The calcium standards (SigmaAldrich) were prepared at various concentrations. Samples and workingsolution was mixed and incubated for 3 minutes. The absorbance was readat 570 nm with a microplate spectrophotometer (Emax, Molecular Devices).

Cell Morphology

For viewing cell morphology, samples were fixed with 4% paraformaldehydeand stained using 4′,6-diamidino-2-phenylindole (DAPI; Invitrogen) forthe nucleus and Alexa Fluor 488 phalloidin (Invitrogen) for F-actin inthe cytoskeleton. Fluorescence images of cells cultured on fibrousscaffolds were taken with a confocal fluorescence microscope (C1-si,Nikon, Japan) on days 7 and 14.

Statistics

SPSS 20.0 software (SPSS Inc., IL, USA) was used for statisticalanalysis of all quantitative analyses. Results are expressed asmean±standard deviation. One-way Analysis of Variance (ANOVA) and thepost hoc multiple comparison using Tukey's test were applied.Probability (p) values <0.05 were considered statistically significantdifferences.

Results

Fiber Morphology and Diameters of the Electrospun PVDF

As shown in FIG. 13, nano-sized fibers were created using acceleratingvoltages of 12, 15, 20, 25, and 30 kV. The calculated fiber diametersare shown in the below table. Although not statistically significant,fiber diameters decreased from 295±112 nm to 151±70 nm with an increasein voltage during electrospinning.

Samples Fiber diameter 12 kV 295 ± 112 nm 15 kV 194 ± 72 nm 20 kV 191 ±94 nm 25 kV 177 ± 84 nm 30 kV 151 ± 70 nm

Above table: fiber diameter of electrospun fibers.

X-Ray Diffraction

FIG. 14 shows the XRD patterns of all electrospun fibers, PVDF film andmelt-spun fibers. For raw PVDF pellets, the XRD peaks were observed at2θ=17.7°, 18.4°, 19.9° and 26.6° and 38.5°, which are characteristic ofalpha-phase. PVDF film and melt spun fibers demonstrated similar peaksas raw PVDF pellets but had smaller to negligible peaks at 2θ=26.6° and38.5°. The spectra of all electrospun fibers consistently showed a broadpeak at 2θ=20.3° which corresponds to β-phase and a smaller broad peakat 18.4° which corresponds to α-phase.

Fourier Transform Infrared Spectroscopy

FTIR spectrum of PVDF pellets exhibited α-phase peaks located at 531,614, 763, 796, 870 and 970 cm^(−1 8,10,15,16) (FIG. 15) Similarly, PVDFfilm and melt-spun fibers at 230° C. showed characteristic α-phase peaksat 614, 763, 796, 870 and 970 cm⁻¹. However, PVDF film did not show anα-phase peak at 532 cm⁻¹. A representative melt-spun fiber spectrum isshown since no differences were observed in the presence and intensitiesof peaks for fibers prepared at different temperatures. In contrast, theelectrospun fibers consistently exhibited peaks primarily of β-phaselocated at 510, 840 and 1278 cm⁻¹. In addition, some smaller α-phasepeaks were still present at aforementioned locations but the peaks at796 and 970 cm⁻¹ were absent. In addition, the α-phase peak at 531 cm⁻¹was absent for fibers electrospun at 25 kV. Interestingly, γ-phase peaksat 812, 882 and 1225 cm⁻¹ were not observed in any of the samples. Fromthese FTIR spectra, relative fractions of β-phase in all electrospunsamples were determined using equation 1, and the results are shown inthe below table. The highest proportion of β-phase was achieved in 25 kVelectrospun scaffolds where the fraction of β-phase was calculated to be72.44%.

Samples β fraction (%) 12 kV 65.90 15 kV 68.50 20 kV 66.86 25 kV 72.4430 kV 68.28

Above table: estimated relative beta-fraction for the electrospunscaffolds.

Differential Scanning Calorimetry

The DSC was performed to determine the changes in thermal properties andcrystal structures for melt-spinning and electro spinning samples andwere compared with raw PVDF pellets. All the samples showed similarendothermic peaks extending from 150° C. to 170° C. The meltingtemperature (T_(m)) and heat of fusion of these samples were determinedfrom DSC curves as shown in the below table. The crystallinity ofsamples was calculated using equation 2. The results indicated lowermelting temperatures for all electrospun fibers than the unprocessedPVDF pellets. The melt-spun fibers' melting temperature were similar toPVDF pellets. The electrospun fibers had statistically highercrystallinity than raw PVDF pellets and melt spun fibers.

Scaffolds Tm (avg) % Xc Pellets 168.58 ± 0.50 43.98 ± 0.81 12 kV 165.91± 0.94 53.84 ± 1.88 15 kV 164.24 ± 1.32 52.10 ± 1.42 20 kV 165.77 ± 1.2453.29 ± 2.11 25 kV 164.74 ± 1.69 53.52 ± 1.66 30 kV 164.99 ± 1.71 52.68± 1.24 MS-230 167.27 ± 0.51 50.29 ± 5.25 MS-240 167.32 ± 0.40 47.14 ±1.34 MS-260 167.22 ± 1.07 46.82 ± 1.20

Above table: DSC data of raw PVDF pellets, meltspun fibers andelectrospun scaffolds samples.

In Vitro Cell Studies

Cell Morphology

The morphology of MSCs seeded on PVDF-12 kV and PVDF-25 kV scaffolds wasevaluated using confocal microscopy. At day 7, cells were attached andspread on both scaffolds (FIGS. 16a and 16b ). At day 14, cells appearedto have grown in number and remained well attached to both scaffolds asshown in FIGS. 16c and 16 d.

Cell Proliferation

Over the course of 21 days in culture, cell proliferation was determinedon TCP, PVDF-12 kV and PVDF-25 kV in control (not shown) and OS (FIG. 6)medium. The TCP group had significantly higher average cell number ascompared to cells on both scaffolds at days 7, 10, and 14 (p<0.05) in OSmedium Similar trend was observed in control medium where TCP group hadsignificantly higher average cell number than both the scaffolds at alltime points (not shown). By day 21, the average number of cells on boththe scaffold groups in control and OS medium was the highest as comparedto all other time points (p<0.05). No significant differences weredetected between scaffolds at all time points in both medium conditions.

Alkaline Phosphatase Activity

ALK activity, an early osteogenic differentiation marker, was determinedfor cells on TCP, PVDF-12 kV and PVDF-25 kV scaffolds at 7, 10, 14 and21 days in control (not shown) and OS medium (FIG. 18). ALK activity incontrol medium for all groups was negligible. In OS medium, the ALKactivity of cells on TCP was significantly lower than PVDF-12 kV andPVDF-25 kV scaffolds at day 7 (p<0.05). By day 10, all three groups weresignificantly different, where PVDF-25 kV scaffold had the highest ALKactivity (p<0.05). By day 21, ALK activity on PVDF-25 kV wassignificantly higher than TCP group. However, there were no significantdifferences observed in ALK activity between both the scaffolds at 21days.

Mineralization Assay

Mineralization/calcium, a mature osteogenic differentiation marker, wasmeasured for cells cultured on TCP, PVDF-12 kV and PVDF-25 kV scaffoldsat 7, 10, 14 and 21 days in control (not shown) and OS medium (FIG. 19).By day 10, the greatest mineralization was detected for cells on PVDF-25kV scaffold as compared to TCP and PVDF-12 kV scaffolds (p<0.05). Theamount of mineralization on both scaffolds increased significantly byday 21 and was higher than TCP group (p<0.05).

Discussion

The aim of this study was to examine the effect of varying theaccelerating voltage during the electrospinning process on the formationof piezoelectric β-phase in PVDF scaffolds. In addition, the osteogenicdifferentiation of MSCs was evaluated on PVDF scaffolds that wereprocessed at different voltages. Varying applied voltage duringelectrospinning appeared to have an effect on β-phase content inelectrospun scaffolds where the β-phase increased with increasingvoltage from 12-25 kV. In addition, the fiber diameter decreased withincreasing voltage. Cells on PVDF mats spun at higher voltages, PVDF-25kV, also had the greatest ALK activity and mineralization as compared toTCP and PVDF-12 kV scaffold groups indicating favorable osteogenicdifferentiation of MSCs.

During electrospinning, applied voltage, solvent choice andconcentration of polymer solution has a major effect in achieving beadfree fibers. In this study, acetone and DMAC were used in a 1:1 ratio.Both DMAC and acetone are considered good solvents that are able topenetrate and dissolve the crystalline part of raw PVDF, which isprimarily α-phase¹⁷. During electrospinning process, acetone evaporatesat a faster rate than DMAC because DMAC has a higher boiling point (165°C.) than acetone (56° C.). It was expected that slower evaporation rateof DMAC would allow fibers to stretch and encourage transformation ofα-phase to β-phase, while acetone would discourage any bead formation.The electrospun PVDF scaffolds achieved had nano-size fiber diametersranging from 295±112 nm to 151±80 nm. Notably, fiber diameters had abroad range as noted by large standard deviation and some bead formationwas also observed especially in samples electrospun at 25 and 30 kV.Similar trends have been noted previously during electrospinningprocess, where the nano-size fibers are primarily achieved as a resultof increase in stretching under high electric field¹². It has beenimplied that under the application of high voltage, the ejecting polymersolution becomes highly charged and overcomes its surface tension. As aresult, a highly charged jet is ejected, which elongates due torepulsion of charges present on its surface^(4,12). In addition, ejectedjets are highly unstable especially at high voltages, which have adirect effect on the rate of solvent evaporation further affecting theformation of beads versus fibers¹². Therefore, thinner and larger rangesof fiber diameters were achieved as voltage increased.

Electrospinning at high voltage also had a direct effect on the T_(m)and crystallinity as determined from DSC thermograms when compared withraw PVDF pellets, film and meltspun fibers. DSC analysis is not capableof discriminating between alpha and beta phases, but it can show if thecrystallinity has changed, which is directly correlated to meltingenthalpy and T_(m) ⁷. When compared to raw PVDF pellets, melt spunfibers and film, the electrospun scaffolds all showed highercrystallinity, corresponding to the higher melting enthalpy. It can beexplained that under high applied voltage combined with a slow flowrate, the polymer solution undergoes increased bending and elongationprocess, which directly influences the crystallization of PVDF^(7,9).Furthermore, when compared to the raw PVDF pellets, the melting peak ofall electrospun scaffolds was broader implying the broad distribution oflamellar thicknesses of the α- and β-phase crystallites formed inelectrospun scaffolds⁷. As a result, the broad endothermic peak mayindicate the overlap of α- and β-phase melting peaks.

Crystal structure evaluation by XRD and FTIR corroborate that theelectrospinning process modified PVDF crystalline phase. In XRDpatterns, the β-phase is indicated by a broad peak with growingintensity as voltage increases from 12-25 kV in the electrospunscaffolds. Similarly, the relative β-phase fraction, estimated from FTIRspectrums, increased in electrospun scaffolds with increasing voltage.Whereas, the XRD and FTIR spectrums for raw PVDF pellets, film and meltspun fibers showed only characteristic α-phase peaks^(8,12). XRD forelectrospun mats showed both β- and α-phases^(6,11). The broadness ofbeta phase peak may be due to the defects in the crystalline latticecaused by the formation of non-uniform, small crystal sizes during theelectrospinning process^(7,12). In addition, it may be that electrospunscaffolds may consist of un-oriented β-phase crystals due to theelectrospinning process where stretched molecular chains of PVDFsolidified prematurely before forming oriented crystal structures¹².

For in vitro osteogenic differentiation evaluation, the PVDF-25 kVscaffold with the greatest relative β-phase fraction was compared toPVDF-12 kV scaffolds and TCP. In this study, TCP group had significantlyhigher average cell number than both the scaffolds. PVDF-12 and PVDF-25kV scaffolds supported MSCs attachment and proliferation over a periodof 21 days.

Osteogenic differentiation assays indicated that electrospun PVDF-25 kVscaffolds had the greatest ALK activity and mineralization by day 10when compared to PVDF-12 kV and TCP groups. These differences could beattributed to the increased amount of β-phase fraction in PVDF-25 kVthan PVDF-12 kV. It can be inferred that cell differentiation issensitive to the differences in the amount of β-phase present inelectrospun scaffolds, and thus affects differentiation. To confirmthis, it has been previously shown that poled PVDF substrates,consisting primarily β-phase, significantly influence thedifferentiation of neuroblastoma cells than unpoled PVDF substrates¹⁸.In addition, the nanosize fibers of electrospun scaffolds offer largesurface area compared with TCP, which may enhance cell attachment forosteogenic differentiation. Without being bound by theory, thedifferences in the β-phase fractions within the scaffolds and the cellattachment and movement on the scaffolds may elicit different levels ofpiezoelectricity from the scaffolds. This difference may have affectedthe differences observed in proliferation, ALK activity andmineralization of MSCs. Since no studies have previously reported theeffect of piezoelectric scaffolds on MSCs osteogenic differentiation, itis important to further investigate the cellular interactions with suchmaterials.

Conclusion

The electrospinning technique offers a simple method of producingpiezoelectric PVDF scaffolds. Higher accelerating voltages used duringthe electrospinning process appears to increase the presence of thepiezoelectric beta-phase. Results also suggest that the PVDF scaffoldsmay be conducive for osteogenic differentiation of MSCs with potentialfor bone tissue engineering applications. Future studies will focus oncharacterizing the electrical output from these electrospun PVDFscaffolds under varying deformations and elucidate cell response onthese materials.

REFERENCES FOR EXAMPLE 6

-   1. Albrektsson T A, Johansson C J. Osteoinduction, osteoconduction    and osseointegration. European Spine Journal 2001; 10:S96-S101.-   2. Agarwal S, Wendorff J H, Greiner A. Use of electrospinning    technique for biomedical applications. Polymer 2008;    49(26):5603-5621.

3 Martino S, D'Angelo F, Armentano I, Kenny J M, Orlacchio A. Stemcell-biomaterial interactions for regenerative medicine. Biotechnologyadvances 2012; 30(1):338-51.

-   4. Weber N, Lee Y S, Shanmugasundaram S, Jaffe M, Arinzeh T L.    Characterization and in vitro cytocompatibility of piezoelectric    electrospun scaffolds. Acta Biomaterialia 2010; 6(9):3550-3556.-   5. Guo H-F, Li Z-S, Dong S-W, Chen W-J, Deng L, Wang Y-F, Ying D-J.    Piezoelectric PU/PVDF electrospun scaffolds for wound healing    applications. Colloids and Surfaces B: Biointerfaces 2012; 96:29-36.-   6. Low Y K M N, Niphadkar N D, Boey F Y, and Ng K W. α- and    β-poly(vinylidene fluoride) evoke different cellular behaviours.    Journal of Biomaterial Science 2011; 22(12):1651-67.-   7. Lund A, Hagström B. Melt spinning of poly(vinylidene fluoride)    fibers and the influence of spinning parameters on β-phase    crystallinity. Journal of Applied Polymer Science 2010;    116:2685-2693.-   8. Yee W A, Kotaki M, Liu Y, Lu X. Morphology, polymorphism behavior    and molecular orientation of electro spun poly(vinylidene fluoride)    fibers. Polymer 2007; 48(2):512-521.-   9. Andrew J S, Clarke D R. Effect of Electro spinning on the    Ferroelectric Phase Content of Polyvinylidene Difluoride Fibers.    Langmuir 2008; 24(3):670-672.-   10. Salimi A, Yousefi A A. Analysis Method: FTIR studies of b-phase    crystal formation in stretched of α and β phases PVDF films. Polymer    Testing 2003; 22(6):699-704.-   11. Gregorio R, Nociti D S. Effect of PMMA addition on the solution    crystallization of the alpha and beta phases of poly(vinylidene    fluoride) (PVDF). Journal of Physics D: Applied Physics 1995;    28(2):432-436.-   12. Gao K, Hu X, Dai C, Yi T. Crystal structures of electro spun    PVDF membranes and its separator application for rechargeable    lithium metal cells. Materials Science and Engineering: B 2006;    131(1-3):100-105.-   13. Briggs T, Treiser M D, Holmes P F, Kohn J, Moghe P V, Arinzeh T    L.-Osteogenic differentiation of human mesenchymal stem cells on    poly(ethylene glycol)-variant biomaterials. 2009;-91A(-4):-984.-   14. Haynesworth S E, Goshima J, Goldberg V M, Caplan A I.    Characterization of cells with osteogenic potential from human    marrow. Bone 1992; 13(1):81-88.-   15. Bormashenko Y, Pogreb R, Stanevsky O, Bormashenko E. Vibrational    spectrum of PVDF and its interpretation. Polymer Testing 2004;    23(7):791-796.-   16. Salimi A, Yousefi A A. Conformational changes and phase    transformation mechanisms in PVDF solution-cast films. Journal of    Polymer Science Part B: Polymer Physics 2004; 42(18):3487-3495.-   17. Gregorio R. Determination of the α, β, and γ crystalline phases    of poly(vinylidene fluoride) films prepared at different conditions.    Journal of Applied Polymer Science 2006; 100(4):3272-3279.-   18. R. F. Valentini T G V, J. A. Gardella Jr. and P. Aebishcer.    Electrically charged polymeric substrates enhance nerve fibre    outgrowth in vitro. Biomaterials 1992; 13(3):183-190.

Example 7 Annealed PVDF-TrFE Enhances MSC Cell Number and CellDifferentiation

Methods and Materials.

Scaffold Fabrication (Electrospinning).

Polymer solutions for electrospinning were prepared with PVDF-TrFE inmethyl-ethyl-ketone (MEK) Random and aligned electrospun scaffolds werecollected on a plate and a rotating drum, respectively. Annealed sampleswere kept at 135° C. for 96 hours and quenched with ice water.

Characterization of Thermal and Piezoelectric Properties Evaluation.

Scanning electron microscopy (SEM) images were taken to evaluate thefiber diameter and orientation. Differential scanning calorimetry (DSC)was used to evaluate thermally active transition such as meltingtemperature. X-ray diffraction (XRD) was performed to evaluate crystalstructure of as-spun and annealed PVDF-TrFE. Thermally-stimulatedcurrent (TSC) was used to confirm piezoelectricity by measuring thecurrent indicating the dipole movement in response to an increase intemperature. In exemplary embodiments, thermal and piezoelectricproperties were evaluated using differential scanning calorimetry (DSC)and thermal stimulated depolarization current (TSDC) on both unprocessedpowder and electrospun PVDF-TrFE. A heat-cool-heat cycle from −60° C. to200° C. with heating and cooling ramp of 7° C./min was used on DSC toevaluate thermally active transition such as crystallization, melting,and phase transition. Electrospun PVDF-TrFE or the powder was sandwichedbetween the two Teflon films and heated from −60° C. to 140° C. for TSDCexperiments [6].

Electric Response.

Electrodes (10 mm×10 mm) were attached to the ends of the scaffold usingsilver conductive epoxy for one embodiment of the present invention. Thescaffold of this inventive embodiment was mechanically deformed at therate of 10 mm/min using Instron. The electrodes were then connected to acustom-made amplifier circuit and the signals were recorded usingMatlab.

Results.

The average fiber diameter of micron-(L) and sub-micron-(S) PVDF-TrFEwere 3.32±0.2 μm and 0.75±0.08 μm, respectively. The melting point ofas-spun of PVDF-TrFE (L) and (S) increased from 147.9° C. and 147.8° C.to 152.4° C. and 154.5° C. after annealing, respectively. The increasein melting temperature suggested an increase in crystallinity due toannealing. XRD results indicated an increase in the intensity of thepiezoelectric beta phase at 20.4° C. and the loss of thenon-piezoelectric alpha phase around 18.5° C. on the annealed incomparison to the as-spun samples. The annealing process induced crystalorganization hence, enhancing the piezoelectric properties.

Piezoelectric materials display electrical activity when deformed. Humanmesenchymal stem cells grown on piezoelectric materials (AnnealedPVDF-TrFE) in a compression bioreactor had greater cell numbers ascompared to materials that displayed less piezoelectric activity(unannealed PVDF-TrFE) (FIG. 20). Studies demonstrate for the first timethat piezoelectric materials undergoing deformation may promote stemcell growth. Studies suggest that the piezoelectric property may be abeneficial feature in biomaterials to promote tissue repair.

This study demonstrates the potential for using an electroactivescaffold as described herein for bone and cartilage tissue repair. Thescaffolds enhanced differentiation.

Example 8 PVDF-TrFE Scaffolds and their Use in Bone and Cartilage TissueEngineering

Introduction

Musculoskeletal connective tissue injuries, specifically total jointinjuries resulting from osteoarthritis or other conditions, aresignificant challenges to repair. Tissue engineering principles havebeen utilized in recent years as an approach for tissue regeneration.Tissue building during development can be imitated by combining cellsand/or biological factors with a biomaterial that acts as a scaffold fortissue development. Stem cells have been sought after as the ideal celltype for tissue engineering therapies because of their ability todifferentiate into various cell types and thus, promote the regenerationor repair of the diseased or damaged tissue of interest.(1;2) Increasingexperimental evidence demonstrates that stem cells can adjust theirproperties according to their surroundings, and select specific lineagesaccording to the cues they receive from their complexmicroenvironments.(3-5) Since the natural extracellular matrix of boneand cartilage, specifically collagen and glycosaminoglycan, displaypiezoelectric activity, we seek to investigate a piezoelectric scaffoldin combination with stem cells for joint repair. Piezoelectric materialsare capable of converting mechanical strain into electrical output andhave been largely unstudied in the tissue engineering field.

The study examined the use of a smart material, permanentlypiezoelectric poly (vinylidene fluoride trifluorethylene) (PVDF-TrFE)copolymer, as a scaffold for stem cell induced cartilage and bonerepair. In order to more closely mimic the structure of the naturalextracellular matrix, PVDF-TrFE was fabricated into a fibrous form.Fibrous scaffolds have a beneficial structural feature for cell adhesionand growth due to their large surface-to-volume and high aspect ratiosresulting from the smallness of the diameter. This structure may alsoenhance the piezoelectric effect due to increased surface area exposureto the surrounding milieu. To date, the use of a piezoelectric materialin combination with stem cells to regenerate functional tissue has notbeen studied.

This study examined an in vitro model to demonstrate stem celldifferentiation and to characterize the piezoelectric effect ofelectrospun PVDF-TrFE. The material properties of the PVDF-TrFE fiberswere also studied. Therefore, in addition to developing a novelcombination therapy for the repair of bone and cartilage defects, thisstudy furthered the scientific understanding of the role ofpiezoelectric, or electromechanical, effects of materials on celldifferentiation.

This study first aimed to fabricate and fully characterize thepiezoelectric properties of the PVDF-TrFR scaffold. Piezoelectric,polyvinylidine fluoride trifluoroethylene (PVDF-TrFE) fibrous scaffoldswere fabricated and characterized for electrical output in conditionsthat more closely mimic the biological setting. Electrical output of thescaffold was evaluated at both a local and bulk level in order tocharacterize the changes in electrical intensity. These findings canthen be correlated with in vitro stem cell differentiation studies.

The study further aimed to investigate the osteogenic and chondrogenicdifferentiation of human MSCs on a piezoelectric PVDF-TrFE scaffold invitro.

It was hypothesized that the use of a fibrous scaffold having similarphysical properties as the native extracellular matrix would stimulatethe differentiation of MSCs. The results obtained with this studydemonstrate that human MSCs on piezoelectric, fibrous meshes grow andexpress enhanced levels of mature chondrocyte markers. Furthermore, onfibrous scaffolds, MSCS undergoing chondrogenesis express a reduction inmarkers for a more mixed phenotype. Differentiation of MSCs with orwithout the use of the piezoelectric scaffold was investigated usingbiochemical and molecular biology techniques. Transcriptional factorsand markers of early and late stage chondrocytes, hypertrophicchondrocytes and osteoblasts were examined.

Background and Significance

Medicine has traditionally treated diseases or damaged tissues throughdrugs and/or surgery. In recent years, the approach to rebuildingtissues inside of the body or creating tissues outside of the body as invitro models has been focused on using tissue engineering principles.Tissue building during development can be imitated by combining cellsand/or biological factors (e.g. growth factors, genes) with abiomaterial that acts as a scaffold for tissue development. Cells cansynthesize new tissue as well as provide the signals needed for tissueformation. Biomaterials can be designed in forms that imitate thenatural organization of the extracellular matrix. Signaling moleculescan be bound or incorporated into the scaffolds to aid in morphogenesis,pattern formation, and cell differentiation. Currently, however, thequality and function of many tissue-engineered therapies still need tobe improved to fully address the clinical need. Innovative technologiesare needed to regenerate tissues that are inherently complex forcomplete functional recovery. Musculoskeletal connective tissue,specifically articular cartilage and the underlying bone tissue, havebeen significant challenges to repair due to their complexity.

Articular cartilage has a limited intrinsic ability to heal. For thisreason, orthopedic management of these lesions remains a persistentproblem for the orthopedist and patient. The importance of treatinginjury to articular cartilage is underscored by the fact that severalmillion people are affected in the United States alone by cartilagedamage. (6) Lesions of articular cartilage typically progress towidespread cartilage destruction and arthritis that is disabling.Surgical procedures to restore articular cartilage in these lesionsinclude debridement, abrasion arthroplasty, microfracturing, autologouschondrocyte transplantation and osteoarticular transfer.(7-9)

At present, none of these techniques have been able to restore a normalcartilaginous surface and have suffered from poor integration with thesurrounding normal articular cartilage. The necessary prerequisite for asuccessful treatment is the integrity of the subchondral bone, whichgives the joint shape and provides differentiation and development ofcartilage tissue.(10) Therefore, therapy of deep osteochondral defectswith a destroyed subchondral layer by one of the above-mentionedtechniques leads to formation of biomechanically insufficient fibrouscartilage.

Current tissue engineering methods are aimed at filling the cartilagedefects with cells or scaffolds alone, or in combination with oneanother.(11;12) It appears that the absence of cells leads to a poorquality reparative tissue. The use of autologous chondrocytes is theonly FDA approved cell-based therapy for cartilage repair, Carticel™(Genzyme, Inc., Cambridge, Mass.). However, of major concern is thelimited proliferative capacity of differentiated chondrocytes inproviding adequate cell numbers for transplantation and theirproliferative capacity decreases with patient age, which poses a problemfor treating age-related osteoarthritis.(13) In addition, long-termstudies in patients have demonstrated that these treated defects arefilled with fibrocartilage as opposed to normal hyaline cartilage, whichmay be a result of poor mechanical stability.(14) Adult stem cells havebeen sought as an alternative cell source.

Mesenchymal stem cells (MSCs) are multipotent cells that are capable ofdifferentiating along several lineage pathways.(15) From a small bonemarrow aspirate obtained from adults, MSCs can be isolated and expandedinto billions of cells due to their proliferative capacity.(16)Additional characterization has also identified a panel ofimmunophenotypic and cell surface markers characteristic of the MSC.(17)In vitro and in vivo analyses have demonstrated that culture expandedMSCs can differentiate into osteoblasts, chondrocytes, adipocytes,tenocytes, myoblasts, and neural cell lineages. MSC populations that hadbeen taken out to 15 passages as well as cyropreserved still have thecapacity to differentiate and proliferate(18-20), suggesting that MSCsmay be valuable as a readily available and abundant source of cells inthe tissue engineering field. Furthermore, recent studies by the PI andothers have demonstrated that the use of allogeneic MSCs cansuccessfully repair bone and other tissue types in various animal modelswithout provoking an adverse immune response.(21) An allogeneic MSCapproach provides an off-the-shelf therapy, where allogeneic MSCs areused as universal cells and in turn, provide cells to a much largerclinical population. They are also currently in clinical trials forvarious disorders or conditions.

In the body, adult stem cells are often localized to specific chemicallyand topologically complex microenvironments, or so-called “niches”.Increasing experimental evidence supports the notion that stem cells canadjust their properties according to their surroundings, and selectspecific lineages according to the cues they receive from their niche.(3-5) In order for an stem cell therapy to be successful in the repairof a specific tissue type, the microenvironment of the cells should bedesigned to relay the appropriate chemical and physical signals to them.Mimicking characteristics of the microenvironment during cartilagedevelopment may be a viable approach. During cartilage development, oneof the earliest events is pre-cartilage mesenchymal cell aggregation andcondensation resulting from cell-cell interaction, which is mediated byboth cell-cell (neural cadherin and neural cell adhesion molecule) andcell-matrix adhesion (fibronectin, proteoglycans, and collagens).(22)Type I collagen being the predominant matrix protein present in theearly stages of development is later transformed to Type II collagen byincreased cell synthesis during differentiation.(23) Multiple growthfactors and morphogens are also present contributing to the regulationof the differentiation process. Similarly, bone during development formsvia mesenchymal cell condensation, cell-matrix adhesion anddifferentiation into the chondrocyte, followed by the hypertrophicchondrocyte (mineralizing chondrocyte) leading to the osteoblast.

Poorly understood physical phenomena in the in vivo microenvironment arelocal electric fields. Extracellular matrix materials, such as thecollagens and glycosaminoglycans mentioned above, display piezoelectricactivity. Specifically, they are capable of converting mechanical straininto electrical output. For type I collagen, a shear stress in the planof polarization produces electric displacement perpendicular to theplane of the applied stress.(24) The electric fields generated inpiezoelectric extracellular matrices may be solely or in part caused bycell-matrix interaction. It is well known that differentiated cellsadhere, contract, and migrate/crawl in and along substrates. For theseprocesses to occur, cells must deform the matrix. In in vitroconditions, cells contract their matrices up to 1-3 μm.(25) At themolecular scale, matrix sensing and deformation by the cell occurs viafocal adhesion complexes that integrate the extracellular matrix withthe actin cytoskeleton.(26-28) The force that the cell generates todeform the matrix results in signal transduction cascades leading toactivation of transcription factors that affect gene expression in thecell. Recent studies by Engler et al (29) have demonstrated that MSCsare sensitive to matrix elasticity and are directed along a specificlineage. No one has studied the effects of a piezoelectric matrix, whichwould convert mechanical deformation or sensing by the cell intoelectrical activity, on stem cell function.

In order to more closely mimic the structure of the naturalextracellular matrix, PVDF-TrFE was fabricated into a fibrous scaffoldusing the electrospinning technique. The micron to nanoscale fiber is abeneficial structural feature for cell adhesion and growth due to itslarge surface-to-volume and high aspect ratios resulting from thesmallness of the diameters. This structure may also enhance thepiezoelectric effect due to increased surface area exposure to thesurrounding milieu. While structural and piezoelectric properties ofPVDF-TrFE films has been widely studied and characterized, not much isknown about electro spun PVDF-TrFE fibers.(39)

This study examined the use of the piezoelectric PVDF-TrFE fibrous meshas a potential scaffold for stem cell induced cartilage and bone tissuerepair. To date, the use of a piezoelectric material in combination withMSCs to regenerate functional tissue has not been studied. This studywill be performed as an in vitro model to demonstrate human MSCdifferentiation and to characterize the piezoelectric effect. Thematerial properties of the electrospun PVDF-TrFE nanofibers were alsoinvestigated.

Results

Fabrication and Characterization of Fibrous Arrays of PVDF-TrFE

The fabrication and characterization of electro spun, non-woven meshesas well as studies of stem cell proliferation and differentiation onthese meshes has been conducted using various polymer and ceramiccompositions.(46-48) Electro spinning process produces meshes with highsurface area, controllable porosity, architecture and mechanicalproperties. Traditional electrospinning has the limitation of producingsheet-like scaffolds or membranes due to the nature of the process,which, in turn, limits its use in vivo. In order to overcome thisproblem, we developed an improved electrospinning technique for thefabrication of thick, continuous electrospun scaffolds (i.e. greaterthan 3 mm in thickness). The technique uses a two power supply setup, incontrast to the commonly used one power supply setup (unpublished data).This novel setup creates a stronger and more focused electrostaticfield, which becomes the driving force for the process.

For the successful formation of fibers, spinning conditions wereestablished (unpublished data).(49) The copolymer poly(vinylidenefluoride-trifluoroethylene) (65/35), PVDF-TrFE, was purchased fromSolvay Solexis, Inc. (NJ). The electrospinning setup consisted of 25%w/v PVDF-TrFE solution in methyl ethyl ketone, 17′ distance from the tipof the needle to the collecting plate, 15 mL/hr flowrate, 25 KV voltageat the tip of the needle and −1 KV at the collector plate, 15% humidityand a temperature of 20.8 Celsius. Micron-sized fibrous scaffolds wereelectrospun using PVDF-TrFE (FIG. 1.a.), having a mean fiber diameter of4±0.4 μm, pore size of 28.2+18.1 μm and porosity of approximately 80%,as determined by capillary flow porometry (PMI, Inc.). MSCs were thenloaded onto the scaffolds and were determined to be evenly distributedthroughout the thickness of the scaffold using confocal microscopy (FIG.21(B)).

Structural Analysis

Differential Scanning calorimetry (DSC) determined the degree ofcrystalinity and confirmed the piezoelectric crystal form was present inthe electrospun PVDF-TrFE mats. Comparisons were made with thepiezoelectric unprocessed powder and solvent-cast film, as well asnonpiezoelectric-unpoled PVDF pellets. The Curie temperature (Tc) andmelting temperature (Tm) peaks in the PVDF-TrFE polymer during the firstand second heating cycle were determined. The differences in the firstheating cycle between the test polymers were not detectable in thesecond heating cycle. This suggests that there is no chemicaldegradation or changes in the chemical structure due to the fabricationprocess. The melting points and heats of fusion for PVDF-TrFE materialswere distinct from values obtained for the unpoled PVDF pellet,indicating that the piezoelectric beta-phase crystal form is present inthe electrospun mat.

Thermally stimulated current (TSC) spectroscopy is widely used tounderstand dielectric relaxation in complex solid systems. TSC is basedon the ability of polar molecules to be moved by an electric staticfield. TSC measurements confirmed that the electrospun PVDF-TrFE fiberscaffolds have internal charges comparable to the original piezoelectricpolymer powder. There was polarization due to the applied electric fieldfollowed by a spontaneous relaxation for both the powder and electrospunforms. X-ray diffraction (XRD) and fourier transform infraredspectroscopy (FTIR) also confirmed the presence of the beta-crystalphase, which is the poled, piezoelectric phase in the electrospunPVDF-TrFE. Unprocessed and electrospun mats had similar spectrum.

Mechanical Properties

The PVDF-TrFE fibrous mats are mechanically flexible and are easy to cutusing standard scissors. The mechanical properties of the micron-sizedPVDF-TrFE fibrous mats, using tensile testing, were a young's modulus of9.44±4.79 MPa., an ultimate tensile stress of 2.05±0.36 MPa., and anultimate tensile strain of 2.48±0.22 mm/mm or 248%. These valuescorrespond to the tensile properties of normal, human articularcartilage of the femoral condyles.(50)

Piezoresponse—Bulk Characterization

For poled PVDF-TrFe films, electrical outputs have been reported to beapproximately 2.5 mV for frequencies within a physiological range(40),which correspond to a charge density of 0.8-1 pC/cm² or a filmdeflection of approximately 1-10 μm (41). The charge output has beenshown to increase linearly with increases in deflection distance.Similarly for non-woven PVDF-TrFE electrospun meshes, electrical outputshave been reported to be approximately 2.5 mV when undergoing vibrationtests at physiological frequencies.(51) These charge densities arewithin therapeutic range for therapies that use AC or DC voltage forwound healing. We investigated the indirect piezoelectric effect toconfirm that our PVDF-TrFE electrospun meshes were piezoelectric byexamining deformation in response to an applied voltage. ElectrospunPVDF-TrFE and polyester (which is nonpiezoelectric as a reference)fibers were connected to an AC voltage (FIG. 22(A)). The fiber movementwas recorded with a high-resolution camera (Coo1SNAP HQ² fromPhotometrics) mounted on a microscope (NIKON SMZ1500). Sine waves withV_(peak to peak)=10 kV at 2 Hz were applied. Still images were taken att=0 and t=0.5 s. The initial and final positions are shown in the FIG.22(B) and the displacement was about 25 μm. No motion was observed forthe reference polyester fiber with the same applied AC voltage.

Piezoresponse—Local Characterization at the Cellular Level

Without being bound by theory, it is hypothesized that the piezoelectriceffect of the scaffold may be imposed via minute deformations of thefiber due to cell adhesion and/or migration, specifically in standard,static cell culture conditions and in vivo. The piezoelectric PVDF-TrFEscaffolds were characterized for electrical output at a local level inorder to characterize the changes in electrical intensity. Local/minutedeformations of the fibers were evaluated using a novel atomic forcemicroscopy (AFM) technique, called piezoforce microscopy (PFM). Thistechnique was developed recently for measuring properties offerroelectric thin films for such applications as sensors and actuators.PFM applies an alternating voltage to the conductive tip in contact withthe material surface resulting in periodic surface displacement due toinverse piezoelectric effect. Mapping of the amplitude and phase of thedisplacement and corresponding electrical output (voltage) can bedetermined. As shown in FIG. 23, the piezoelectric scaffold has ananoscale roughness, as determined by standard AFM. The piezoresponsewas detected at a 200 nm scale with PFM voltages ranging from +-1V (peakto peak) to +-5 Vpp (FIG. 24). No response was detected fornonpiezoelectric meshes.

MSC Growth and Differentiation Along the Chondrogenic Lineage onPVDF-TrFE Meshes

Human MSCs were seeded at a high density on PVDF-TrFE meshes andcultured in standard growth media or chondrogenic induction media. Cellgrowth as measured by metabolic activity and DNA was comparable to cellsseeded onto poly L-lactic acid (PLLA) scaffolds, having comparable fiberdiameters, and tissue culture polystyrene for up to 28 days. Cellsadhered to the PVDF-TrFe mesh with a spread morphology in growth media,and in chondrogenic media, cells aggregated as shown by actincystoskeleton organization and DAPI nuclear stain (FIG. 25).Glycosaminoglycan production for cells on PVDF-TrFe meshes wassignificantly higher than cells on PLLA or in pellet culture (positivecontrol) in inductive media (FIG. 26). Greater gene expression forchondroadherin, collagen type II, focal adhesion kinase (FAK), and Sox9, a transcription factor for chondrogenesis, was determined for cellson PVDF-TrFE meshes in inductive media (FIG. 27) as compared to cells onPLLA and pellet cultures, except for chondroadherin where values werecomparable to pellet cultures. It was interesting to note that highlevels of chondrocytic markers are only expressed in inductive media,suggesting electrical activity coupled with certain growth factors, suchas transforming growth factor beta-3 (TGF-β3), result in a signaltransduction cascade that will further promote chondrogenesis (52).

Further analysis of the gene expression of human MSCs undergoingchondrogenic differentiation on annealed PVDF-TrFE fibrous scaffolds,where annealing increases the piezoelectric beta-phase crystallinity inthe material, was studied in standard static cultures. Comparisons weremade with cells seeded on unannealed PVDF-TrFE fibrous scaffolds, whichserves as a control substrate having the same chemistry but lowerbeta-phase content. Cells seeded on annealed PVDF-TrFE scaffoldsexpressed significantly higher levels of early and late stage markersfor chondrocytes, such as aggregan, chondroadherin, collagen type II andSox-9, as compared with cells on unannealed PVDF-TrFE (FIG. 28). Thisfinding suggests that the piezoelectric property of the scaffoldenhances chondrogenesis. It was also interesting to note that cellsseeded on PVDF-TrFE scaffolds, whether annealed or unannealed, expressedlower levels of Sox-2, which is typically expressed at high levels inthe MSC (undifferentiated), as compared to the standard pellet cultures.Although the pellet culture serves as a positive control, studies havereported that MSCs in pellet cultures, without the use of a scaffold,exhibit mixed phenotypes as opposed to the hyaline phenotype typicallydisplayed by chondrocytes during chondrogenesis.(53) This data suggeststhat the use of a scaffold, in particular a piezoelectric scaffold, maybetter support the chondrogenic differentiation of MSCs as opposed todirect injection of MSCs into the cartilage defect.

Materials and Methods

Scaffold Fabrication

As described in the results, PVDF-TrFE fibrous scaffolds can be createdusing the electrospinning technique. The high accelerating voltage anduniaxial stretching of the viscous solution during the electrospinningprocess results in fibers containing a poled, piezoelectric phase.(54)An annealed PVDF-TrFE fibrous mesh can also be fabricated by heating themesh and quenching in order to increase the piezoelectric beta-phasecrystal size and crystallinity. Unannealed PVDF-TrFE will serve as acontrol in this study and will have the same geometry (fiber size andporosity) as the annealed PVDF-TrFE mesh. Other polymer processingtechniques could be investigated to achieve fibrous structures withlarge pore sizes and porosities. However, electrospinning allows for asimple and efficient process to create poled scaffolds due to the largeelectric field applied during the process.

Structural Characterization

Meshes can be confirmed by the presence of the alpha phase or betaphase, respectively, using x-ray diffraction (XRD) and differentialscanning calorimetry (DSC). Surface chemistry and morphology of meshescan be analyzed by electron spectroscopy for chemical analysis (ESCA),scanning electron microscopy (SEM) and air-water contact angle bygoniometer.

The fiber size of the scaffolds can be determined from the SEM imagesusing Image J software (National Institutes of Health, USA), asdescribed elsewhere.(48) The porosity can be determined by using thedensity values of the raw material and the mat, which was adapted from apreviously published protocol. The density of the electro spun mat(D_(mat)) can be calculated by measuring the diameter and thickness ofthe mat to determine the volume and the mass of the mat using ananalytical balance. D_(mat) can then determined by dividing the mass ofthe mat by its volume. Thirty samples will be measured from each mat tofind the porosity of the mat. The porosity will be calculated using theformula:

Porosity (%)=(1−D _(mat) /D _(raw))*100, where D _(raw), is density ofPVDF-TrFE.

The mean pore diameter can be determined by capillary flow analysis(1100 AEX Capillary Flow Porometer, Porous Materials, Inc. AnalyticalServices Division, Ithaca, N.Y.). Tensile testing, using ASTM Standard D882-02: Standard Test Method for Tensile Properties of Thin PlasticSheeting, will also be performed to assess bulk mechanical properties.

Characterization of the Localized Electrical Activity

Localized electromechanical properties at the nanoscale can be evaluatedby piezoforce microscopy (PFM), which is a specialized atomic forcemicroscopy (AFM) technique. This technique has been developed recentlyfor measuring properties of ferroelectric thin films for suchapplications as sensors and actuators. This technique was recentlyapplied to measuring the nanoscale piezoelectric heterogeneities withinindividual collagen fibrils.(56) PFM applies an alternating voltage tothe conductive tip in contact with the material surface resulting inperiodic surface displacement due to inverse piezoelectric effect.Mapping of the amplitude and phase of the displacement at a resolutionof ˜3-10 nm can be achieved. Local piezoelectric coefficients will bedetermined. The direct voltage (charge) generating capabilities of suchfibers can be determined upon deformation with specializedelectromechanical characterization tools.(57) To our knowledge, thiswill be the first time this technique will be utilized for theapplication of electro spun meshes for biomedical applications. Therange of deflection distances used in this technique will based onprevious work where cells were observed to contract their matrices up to1-3 μm.(25) Collagen fibrils have young's moduli ranging from 200 to 500MPa (58) and have significant contraction/deformation in culture (59).Fiber deformations of the PVDF-TrFE scaffolds are expected since theyoung's moduli of the bulk fibrous samples were approximately 9 MPa andhave been reported for films to be 160 MPa. Time-lapse imaging duringMSC differentiation can also be performed on these scaffolds to quantifyfiber deformation over time. Therefore, the data obtained here can bedirectly correlated to measurements determined in our culture.

Characterization of the Bulk Electrical Activity

The piezoelectric materials act as highly sensitive mechanoelectricaltransducers that can generate charges in response to minute vibrationalforces/deformations. In addition to the PFM characterization, thescaffold will undergo testing using a PZT (lead zirconate titanate)actuator which can be used as a cantilever beam (bimorph configuration)to measure electric output of the scaffold as function ofdisplacement/deflection, according to previously reported protocols.(51)The electrospun PVDF-TrFE can be attached firmly to PZT actuator byapplying a very thin layer of epoxy followed by a curing and settingprocess of the resin. The experiments can involve actuating the PZT beamby applying sinusoidal voltages of specific amplitude and frequency. Thedeflection of the beam can be transferred to the electrospun mat thatcan be attached firmly to it. The resulting strain induced in the matwill generate a voltage across its face due to the piezoelectric effect,which will be recorded along with deflection distance of the beam.Deflection distances and frequencies will correspond with frequenciesand strains commonly used to characterize cartilage in dynamiccompression testing(60), which can be the same setting used for thedynamic compression bioreactor studies above. The data obtained in theseexperiments can then be directly related to the differentiation culturesundergoing dynamic compression.

Study Design for In Vitro Differentiation Studies

Human MSCs can be evaluated for osteogenesis and chondrogenesis grown onannealed and unannealed scaffolds. Cell growth and differentiation canbe evaluated using biochemical, histological and molecular biologytechniques for up to 28 days. Both static and dynamic culture conditionscan be examined. Findings can be correlated with electromechanicalcharacterization results.

Cell Isolation and Culture

Human bone marrow from two healthy donors can be purchased from Lonza,Inc. or another commercial source. Bone marrow can be processedaccording to previously published protocols.(61) Briefly, marrow samplescan be fractionated by centrifugation over a density cushion and platedon tissue culture flasks in Dulbecco's Modified Eagle's Medium (DMEM)containing 10% fetal bovine serum and 1% antibiotic (standard growthmedia). Cultures can be maintained at 37° C., 5% CO₂. Colony formationcan be monitored for a 14-17 day period and then, cells can besubcultured. Cells can be examined for morphology and cell surfacemarkers typical for undifferentiated MSCs.(15) Cells that express CD44,CD29 and SH2, and do not express CD14, CD45, and CD34 surface antigenscan be verified by fluorescence-activated-cell-sorter.

Chondrogenesis and Osteogenesis Culture (Static Conditions)

The osteogenic and chondrogenic differentiation of MSCs can be evaluatedon piezoelectric scaffolds. MSCs can be seeded onto annealed PVDF-TrFEand unannealed PVDF-TrFE meshes (having a thickness of approximately 100micron), grown in standard pellet cultures (as a positive/negativecontrol for chondrogenesis) or grown on tissue culture plastic (as apositive/negative control for osteogenesis). Scaffolds can be insertedin 96-well polypropylene plates and the pellet cultures can be grown incentrifuge tubes. They can be cultured in 1) osteogenic inductive medium(OS) consisting of standard growth medium supplemented with 10 mM betaglycerophosphate (Sigma), 50 μM L-ascorbic acid phosphate (Wako,Richmond, Va.) and 100 nM of dexamethasone (Sigma), 2) serum-freechondrogenic inductive complete medium (CCM+) consisting of 1 mM sodiumpyruvate (Sigma), 0.1 mM ascorbic acid-2-phosphate (Wako), 1×10⁻⁷ Mdexamethasone (Sigma), 1% ITS+ (Collaborative Biomedical Products), and10 ng/mL recombinant human TGF-β3 (Oncogene Sciences) dissolved inDMEM-low glucose, or 3) standard growth media.(62;63) These mediaconditions were chosen to evaluate MSC differentiation on these meshesin the presence of inductive factors or without inductive cues todetermine the influence of the scaffold on differentiation.

Analysis of Differentiation

All assays can be performed at days 4, 7, 14 and 28, unless otherwisenoted. Proliferation can be evaluated for all scaffold groups andcontrols. Proliferation and metabolic activity can be evaluated by DNAquantitation and MTT assay (as described in the results section). Forchondrogenesis, chondrogenic pellets formed from MSCs and cell-ladenscaffolds can be harvested and analyzed for glycosaminoglycan, Type IIcollagen, and proteoglycan synthesis. Glycosaminoglycan and proteoglycansynthesis can be measured quantitatively using an ELISA kit (Blyscan™Kit, Accurate Chemical and Scientific Corporation, Westbury, N.Y.).(64)Type II collagen synthesis can be measured by an ELISA kit(Arthrogen-CIA, Chondrex, Inc.). TGF-beta3 synthesis in the culturemedia can be measured by ELISA kit (R&D systems). For osteogenesis,alkaline phosphatase activity can be measured by quantifying theconversion of para-nitrophenyl phosphate to para-nitrophenol (Sigma).The alkaline phosphatase activity can be normalized to cell numberdetermined from the cell proliferation data expressed as nmol ofp-Np/min/cell. Osteocalcin production will be determined using harvestedsamples obtained at days 14 and 28 using an ELISA assay(MetraBiosystems, Mass.).

Confocal microscopy can be utilized to visualize the cell interactionand overall morphology of the cells on the scaffolds using actincystoskeleton stain (Alexa Fluor 488 phalloidin; Invitrogen, USA) and anuclear stain ((4′,6-diamidino-2-phenylindole, DAPI; Invitrogen, USA)for all groups.

Real-time RT-PCR can be performed as described in the preliminaryresults section for the gene expression of early, mid-stage and latemarkers of chondrogenesis and osteogenesis at days 1, 7, 14 and 28 days.For chondrogenesis, early markers of fibromodulin and cartilageoligomeric matrix protein, mid-stage markers of aggrecan and versican,mature chondrocyte markers for type II collagen and chondroadherin, andsox9, a transcription factor, can be evaluated. Additional factors thatcan be analyzed are Sox-2, Oct-4 and NANOG as a marker for theundifferentiated MSC, as an indicator of stem cell self-renewal andmaintenance.(65)

Based on the data, TGF-beta3 can also be investigated since itsexpression is associated with signal transduction via thecalcium/calmodulum. Its pathway becomes activated in chondrocytes duringmechanotransduction when exposed to mechanical stress as well aselectric fields.(33;66) Chondrocyte hypertrophic markers of Type Xcollagen, Type I collagen, matrix metalloproteinase 13, vascularendothelial growth factor (VEGF) and alkaline phosphatase can also beexamined.(67) Gene expression at day 0 for MSCs and human articularchondrocytes (obtained from two healthy donors from Asterand, Inc.) canserve as controls. Osteogenic markers of Runx2, which is a transcriptionfactor, osteopontin, osteocalcin as well as type I collagen can beinvestigated. Quantitative RT-PCR analysis can be performed with the OneStep QuantiTect SYBR Green RT-PCR Kit (Qiagen, Calif., USA) using theMX4000 detection system (Stratagene, Calif., USA), according to themanufacturers' instructions. Briefly, cells can be harvested. Total RNAcan be isolated using the RNeasy Mini Kit (Qiagen) including thehomogenization (QIA Shredder; Qiagen) and DNA digestion step (RNase FreeDNase Set; Qiagen). The reverse transcription step can run for 30 min at50° C., followed by PCR activation for 15 min at 95° C. Fortyamplification cycles can run, consisting of 15 s denaturation at 94° C.,30 s of annealing at 55° C., and 30 s of extension at 72° C. For eachreaction, a melting curve analysis of the RT-PCR product can beincluded. Samples can be assayed and the values can be normalized to therelative amounts of the housekeeping gene RPLPO (ribosomal protein,large, PO) according to Muller et al.(68)

Protein level expression for Oct-4, Sox-2, and Nanog can be evaluatedusing western analysis.(65) Briefly, rabbit anti-Oct4, -SOX-2, -NANOG,and fluorescein isothiocyanate (FITC)-goat anti-rabbit can be purchasedfrom Abcam (Cambridge, M.A.). Nuclear proteins can be extracted with theExtract kit according to the manufacturer's specified guidelines(Sigma-Aldrich). Total protein can be determined with a Bio-Rad(Hercules, Calif.) DC protein assay kit. Extracts can be treated withprotease inhibitor and analyzed using 4%-20% SDS-polyacrylamide gelelectrophoresis precast gels (Bio-Rad). Proteins can be transferred ontomembranes (PerkinElmer Life and Analytical Sciences) and incubatedovernight with primary antibodies. Detection will g3 performed withHRP-conjugated IgG. Primary and secondary antibodies can be used atdilutions of 1/1,000 and 1/2,000, respectively. Membranes were strippedwith Restore Stripping Buffer (Pierce, Rockford, Ill.) for reprobingwith other antibodies. Cytoplasmic contamination of nuclear extracts canbe determined by reprobing the membranes with anti-ribosomal proteinL28.

Time-lapse Confocal Microscopy for Measuring Fiber Deformation

Cells on PVDF-TrFE scaffolds can be observed using time-lapse imaging ona confocal microscope, as previously described.(63) The goal is toobserve fiber deformation in response to cell movement or attachmentover time. Briefly, cells on scaffolds can be cultured in inductive andstandard growth medium in 37° C., 5% CO₂ incubator. Cells can beharvested at time-points of days 0, 14, and 28, which correspond toassay time points in the cultures. Cells can be stained with CellTracker (Invitrogen) and placed in CO₂ independent medium (Invitrogen)for viewing on a 37° C. incubated microscope stage on a Nikon C1-siconfocal system with the TE2000E inverted microscope with a HC Plan APOCS 20×/0.4 air lens. Fibers have a red autofluoresence. Images can betaken at 10 minute intervals over 18 hours. Fiber deformation distancesover time can be measured using EZ-C1 analysis software. The averagefrequency of deformation (distance/time) can be calculated.

Dynamic Compression Cultures

Cultures subjected to dynamic compression can be performed using theC10-12c CartiGen Bioreactor System (Tissue Growth Technologies, Inc.,Minnetonka, Minn., http://www.tissuegrowth.com/prod_cartilage.cfm). Thisbioreactor system is commercially available, specifically designed forcartilage tissue engineering projects and is simple to use (technicaltraining and support from the company is provided). In addition, the PIslaboratory has experience using bioreactors.(69) This bioreactor appliesoscillatory compressive stimulation of up to 12 samples at once in thechamber. Samples are held in separate wells so different mediaconditions can be used on each sample. Scaffolds of the dimension of 4mm in diameter×5 mm thick will be used. MSCs can be vacuum loaded, aspreviously described(21), in order to achieve a homogeneous distributionof cells throughout the thickness of the scaffold. Cell-seeded scaffoldscan then be subjected to the following parameters: dynamically tested inunconfined compression with a peak-to-peak compressive strain amplitudeof 10 percent, at a frequency of 1 Hz, 3× (1 hour on, 1 hour off)/day, 5days/week for 4 weeks.

These parameter were chosen based on reported protocols for dynamicloading of functional, cartilage tissue engineered scaffolds that mimicthe in vivo conditions.(70) Both chondrogenesis and osteogenesis mediaconditions as well as standard growth media can be investigated.Biochemical and gene expression studies can be performed as describedabove for the static culture. Histological characterization can also beperformed. Briefly, histological staining can be performed on thecell-laden scaffolds as well as pellets at days 7, 14 and 28. Allsamples can be fixed in formalin 10%, dehydrated through gradedalcohols, and embedded in paraffin. Sections can be cut at a thicknessof 5 μm and stained with Alcian blue, Safranin-O, and Sirius Red todetect sulfated and carboxylated acid mucopolysaccharides and sulfatedand carboxylated sialomucins, proteoglycans, and different collagentypes in tissue sections, respectively. Masson's trichrome stain can beused for detecting bone. H&E can also be used. Cell morphology can alsobe observed. Direct comparisons can be made with results from the staticculture studies.

Group Size and Statistical Analyses

The experimental groups are: MSCs seeded onto annealed PVDF-TrFE andunannealed PVD-TrfE, pellet cultures, and tissue culture polystyrene.All of these groups can be cultured in either standard growth media(control), chondrogenic induction media (CCM+) or osteogenic inductionmedia (OS). Unless otherwise stated, the quantitative assays can beperformed on days 4, 7, 14, and 28 or days 1, 14 and 28 days for geneexpression. A sample size, n of 6, will be used to detect statisticaldifferences for all quantitative biochemical and proliferation assays. Asample size, n of 9, can be used for quantitative gene expression usinga 96-well plate format as performed in the preliminary results section.This sample size was determined based on a power analysis using an alphaof 0.05, power of 0.8, and standard deviations based on preliminary datadescribed in this proposal. These studies can be repeated using twodifferent donors and repeated per donor. For the time-lapse fiberdeformation studies, a minimum of 10 fibers per image can be analyzedand averaged. One way and two way ANOVAs can be performed to test forstatistical differences between groups at each time point and over time,respectively for p<0.05. The Tukey-Kramer Method, p<0.05, can be used toperform multiple comparisons between groups.

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Example 9 Repair of Osteochondral Defect In Vivo Using PVDF-TrFEScaffold

The PVDF-TrFE scaffold was implanted in an osteochondral defect for 12weeks (n=3) as a preliminary in vivo study and findings demonstratedthat the scaffold was biocompatible, filled with cartilage andintegrated with surrounding cartilage and bone tissue. (See FIG. 29).

Although the systems and methods of the present disclosure have beendescribed with reference to exemplary embodiments thereof, the presentdisclosure is not limited thereby. Indeed, the exemplary embodiments areimplementations of the disclosed systems and methods are provided forillustrative and non-limitative purposes. Changes, modifications,enhancements and/or refinements to the disclosed systems and methods maybe made without departing from the spirit or scope of the presentdisclosure. Accordingly, such changes, modifications, enhancementsand/or refinements are encompassed within the scope of the presentinvention.

REFERENCES

The following references are incorporated herein by reference in theirentirety for all purposes.

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We claim:
 1. An electroactive structure for growing and differentiatinga differentiable cell comprising a three dimensional matrix ofelectrospun biocompatible synthetic piezoelectric polymer fibers formedby electro spinning the polymer at a high electric potential, whereinthe fiber matrix forms a scaffold for supporting cell growth anddifferentiation; and wherein the scaffold conditions are sufficient toinduce differentiation of a mesenchymal stem cell into either anosteogenic or chondrogenic phenotype.
 2. The electroactive structureaccording to claim 1, wherein the biocompatible synthetic piezoelectricpolymer is a homopolymer, a copolymer or combination thereof.
 3. Theelectroactive structure according to claim 2, wherein the homopolymer isa polyvinylidene fluoride (PVDF), or a trifluoroethylene polymer.
 4. Theelectroactive structure according to claim 2, wherein the copolymer is apoly(vinylidene fluoride trifluoroethylene) (PVDF-TrFE) copolymer. 5.The electroactive structure according to claim 3, wherein thebiocompatible synthetic piezoelectric homopolymer fibers are annealed.6. The electroactive structure according to claim 4, wherein thebiocompatible synthetic piezoelectric copolymer fibers are annealed. 7.The electroactive structure of claim 6, wherein the matrix of fibersfurther comprises a growth factor capable of further promoting thedifferentiation of the mesenchymal stem cell into a osteogenic orchondrogenic phenotype.
 8. The electroactive structure of claim 7,wherein the growth factor is associated with the matrix of fibersthrough at least one of a covalent interaction, a non-covalentinteraction or a combination of both.
 9. The electroactive structureaccording to claim 1, wherein the matrix fibers is a non-woven mesh ofnanofibers, microfibers or a combination of both.
 10. The electroactivestructure according to claim 1, wherein matrix fibers are arranged inthe matrix randomly, substantially aligned or a combination of both. 11.The electroactive structure according to claim 5, wherein the fibers arethermally or chemically annealed, and wherein after annealing the fibersdemonstrate enhanced piezoelectric characteristics, crystal organizationor a combination of both.
 12. The electroactive structure according toclaim 6, wherein the fibers are thermally or chemically annealed, andwherein after annealing the fibers demonstrate enhanced piezoelectriccharacteristics, crystallization, crystal structure or a combinationthereof.
 13. The electroactive structure according to claim 1, whereinthe osteogenic or chondrogenic phenotype is demonstrated by at least oneof increased collagen expression, growth or a combination thereof. 14.The electroactive structure according to claim 1, wherein the highelectric potential is a voltage of at least between 15 to 30 kV.
 15. Theelectroactive structure according to claim 1, wherein the high electricpotential is 25 kV.
 16. An implantable electroactive scaffold producedaccording to the steps comprising: (a) electropsinning a biocompatiblesynthetic piezoelectric polymeric material at at least 25 kV to form athree-dimensional matrix of piezoelectric fibers, wherein the fibershave an average fiber diameter of from about 500 nm to about 5 μm; (b)annealing the electrospun piezoelectric polymeric fibers; and (c)seeding the annealed three-dimensional matrix of piezoelectric fiberswith a mesenchymal stem cell under conditions sufficient to inducedifferentiation of a mesenchymal stem cell into either an osteogenic orchondrogenic phenotype.
 17. The implantable electroactive scaffold ofclaim 16, wherein the biocompatible synthetic piezoelectric polymericmaterial is at least one of a homopolymer, a copolymer or a combinationof both.
 18. The implantable electroactive scaffold of claim 17, whereinthe homopolymer is a polyvinylidene fluoride (PVDF), or atrifluoroethylene polymer.
 19. The implantable electroactive scaffold ofclaim 17, wherein the copolymer is a poly(vinylidene fluoridetrifluoroethylene) (PVDF-TrFE) copolymer.
 20. The implantableelectroactive scaffold of claim 17, further comprising the step ofshaping the scaffold using a presss or mold.